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Detection of hematogenic and lymphogenic tumor cell dissemination in patients with medullary thyroid carcinoma by cytokeratin 20 and preprogastrin‐releasing peptide RT‐PCR
Author(s) -
Weber Theresia,
Lacroix Jeannine,
Wörner Stefan,
Weckauf Helgard,
Winkler Steffi,
Hinz Ulf,
Schilling Tobias,
FrankRaue Karin,
Klar Ernst,
Knebel Doeberitz Magnus von
Publication year - 2002
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.10804
Subject(s) - medicine , pathology , lymph , bone marrow , lymph node , cervical lymph nodes , medullary cavity , cytokeratin , thyroid carcinoma , thyroid , metastasis , cancer , immunohistochemistry
Abstract Despite an extensive surgical approach only 50% of the patients with medullary thyroid carcinoma (MTC) are biochemically cured. The failure to cure a larger number of patients is a result of the early dissemination of MTC. The present study evaluates two RT‐PCR based assays for the detection of disseminated tumor cells in blood, bone marrow and lymph node samples of patients with MTC. Frozen tissue and blood samples of 19 patients with MTC and 61 cervical lymph nodes of these patients were obtained intraoperatively during thyroidectomy and lymphadenectomy. Preoperative bone marrow samples were obtained from 8 patients with MTC. An expression of CK20 and preproGRP was found in all MTC tissue samples. Using CK20‐PCR, disseminated MTC cells were detected in 67% of the cervical lymph nodes of patients with MTC, compared to 72% involved lymph nodes, detected by preproGRP‐PCR. In 16 of 61 nodes (26%) each PCR‐system detected disseminated tumor cells in histologically tumor‐free lymph nodes. Disseminated tumor cells were detected with CK20‐PCR and preproGRP in 5 of 18 (28%) preoperative blood samples, each. The detection of a hematogenic tumor cell dissemination by preproGRP correlated significantly with the tumor stages ( p = 0.019). Circulating MTC cells were found in 3 of 8 bone marrow samples with CK20‐PCR, compared to 1 of 8 samples with preproGRP‐PCR. Both PCR assays are highly sensitive to detect disseminated MTC cells in blood, bone marrow and lymph node samples. Our results of disseminated MTC cells in 26% of histologically tumor‐free cervical lymph nodes and in 28% of the blood samples of patients with MTC might therefore explain the low biochemical cure rates. © 2002 Wiley‐Liss, Inc.