Premium
Quantification of cytokeratin 20, carcinoembryonic antigen and guanylyl cyclase C mRNA levels in lymph nodes may not predict treatment failure in colorectal cancer patients
Author(s) -
Bustin Stephen A.,
Siddiqi Shahab,
Ahmed Shafi,
Hands Rebecca,
Dorudi Sina
Publication year - 2003
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.11596
Subject(s) - carcinoembryonic antigen , cytokeratin , medicine , colorectal cancer , lymph , guanylate cyclase 2c , lymph node , oncology , oncofetal antigen , pathology , cancer , messenger rna , stage (stratigraphy) , biology , immunohistochemistry , receptor , guanylate cyclase , gene , immunotherapy , paleontology , biochemistry , tumor associated antigen
Conventional histopathologic staging of primary colorectal cancers does not allow accurate prognostic stratification within a given tumour stage. Therefore, PCR‐based assays are increasingly used to try to predict more accurately the likelihood of disease progression for the individual patient. Real‐time reverse transcription PCR (RT‐PCR) assays were used to detect and quantitate cytokeratin 20 (ck20), carcinoembryonic antigen (CEA) and guanylyl cyclase C (GCC) mRNA in 149 lymph nodes (LN) from 17 patients with benign disease and 302 LN from 42 patients with colorectal cancer who had curative (R0) resections. None of the markers were specific, with ck20, CEA and GCC mRNA detected in 47%, 89% and 13% of 149 LN, respectively, from patients with benign disease. The sensitivity of all 3 markers was very high, with mRNA detected in 93%, 100% and 97% of 30 histologically involved LN, respectively. There was significant overlap in the mRNA levels of all 3 markers between histologically involved and uninvolved LN. There was no association between mRNA levels and distant recurrence (median follow‐up: 3.94 years, range 3.35–5.12). We conclude that the use of molecular techniques to detect occult disease in LN may suffer from the same limitations as conventional methods. Instead, accurate prognostic stratification requires careful assessment of the likely metastatic potential of the primary cancer. © 2003 Wiley‐Liss, Inc.