J Korean Surg Soc.  2012 Jun;82(6):356-364.

Influence of surgical manipulation and surgical modality on the molecular detection of circulating tumor cells from colorectal cancer

• Park SY
• Choi GS
• Park JS
• Kim HJ
• Ryuk JP
• Choi WH

Abstract

PURPOSE
The aim of this study was to evaluate the relationship between the detection of circulating tumor cell molecular markers from localized colorectal cancer and the time-course of a surgical manipulation or surgical modality.
METHODS
From January 2010 to June 2010, samples from the peripheral blood and the inferior mesenteric vein were collected from 42 patients with cancer of the sigmoid colon or rectum. Pre-operative, intra-operative (both pre-mobilization and post-mobilization), and post-operative samples were collected. We examined carcinoembryonic antigen (CEA) mRNA and cytokeratin-20 (CK20) mRNA by real-time reverse-transcriptase polymerase chain reaction. Changes in mRNA detection rates were analyzed according to the time of blood sample collection, the surgical modality, and patient clinicopathological features.
RESULTS
mRNA expression rates before surgical resection did not differ between blood samples from the peripheral and inferior mesenteric veins. The detection rate for CEA and CK20 mRNA showed a tendency to increase after operative mobilization of the cancer-bearing bowel segment. Furthermore, the cumulative detection rates for CEA and CK20 mRNA increased significantly over the course of surgery (pre-mobilization vs. post-mobilization). The cumulative detection rate decreased significantly after surgical resection compared with the pre-operative rates. However, no significant difference was observed in the detection rates between different surgical modalities (laparoscopy vs. open surgery).
CONCLUSION
The results of this study suggest that surgical manipulation has a negative influence on the dissemination of circulating tumor cells during operations on localized colorectal cancer. However, the type of surgical technique did not affect circulating tumor cells.

Keyword

Colorectal cancer; Circulating tumor cells; mRNA

MeSH Terms

Carcinoembryonic Antigen
Colon
Colorectal Neoplasms
Humans
Keratin-20
Mesenteric Veins
Neoplastic Cells, Circulating
Polymerase Chain Reaction
Rectum
RNA, Messenger
Sigmoid Neoplasms
Carcinoembryonic Antigen
Keratin-20
RNA, Messenger

Figure

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  Fig. 1 Time-frame for collecting blood sample. PV, peripheral vein; IMV, inferior mesenteric vein.

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  Fig. 2 Blood samples from the inferior mesenteric vein were obtained by direct puncture with a 23-gauge needle.

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  Fig. 3 Comparison of circulating tumor markers (sampled from the inferior mesenteric vein) between the pre-mobilization and post-mobilization time-points. CEA, carcinoembryonic antigen; CK20, cytokeratin-20. a)P < 0.05.

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  Fig. 4 Comparison of circulating tumor markers (sampled from the peripheral vein) between the pre-operative and post-operative time-points. CEA, carcinoembryonic antigen; CK20, cytokeratin-20. a)P < 0.05.

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  Fig. 5 Comparison of circulating tumor markers (sampled from the peripheral vein) between the pre-operative and post-operative day 4 time-points. CEA, carcinoembryonic antigen; CK20, cytokeratin-20.

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