Affiliations: MedicoGenomic Research Center, Kaohsiung Medical
University, Kaohsiung, Taiwan | Department of Surgery, Kaohsiung Medical University,
Kaohsiung, Taiwan | Department of Internal Medicine, Kaohsiung Medical
University, Kaohsiung, Taiwan | School of Biomedical Science and Environmental
Biology, Kaohsiung Medical University, Kaohsiung, Taiwan | Asia Hepato Gene Co., Ltd., Kaohsiung, Taiwan
Note: [] Corresponding author: Jaw-Yuan Wang, M.D., Ph.D., Department of
Surgery and MedicoGenomic Research Center, Kaohsiung Medical University, No.
100, Shih Chuan 1st Road, Kaohsiung 807, Taiwan. Tel.: +886 7 3122805; Fax:
+886 7 3114679; E-mail: cy614112@ms14.hinet.net
Abstract: Early detection of disseminated tumor cells in the peripheral blood
of patients with early stage gastric cancer could help to improve the outcome
after tumor resection. The aim of this study is to evaluate the prognostic
significance of tumor-related mRNA for the detection of circulating tumor cells
in gastric cancer patients by a reverse-transcriptase polymerase chain reaction
(RT-PCR) method. We simultaneously analyzed human telomerase reverse
transcriptase (hTERT), cytokeratin-19 (CK-19), cytokeratin-20 (CK-20) and
carcinoembryonic antigen (CEA) mRNA (messenger RNA) expression in the
peripheral blood of 42 gastric cancer patients and 30 healthy individuals.
Additionally, analyses were carried out for the correlation of these four
molecular markers with patients' clinicopathologic features, as well as the
occurrence of postoperative recurrence/metastasis. Among 42 gastric cancer
patients, the prevalence of mRNA for hTERT, CK-19, CK-20, and CEA was 61.9%
(26/42), 69% (29/42), 61.9% (26/42), and 78.6% (33/42), respectively. All 30
healthy individuals were negative for hTERT and CEA mRNA, while two were
positive for either CK-19 mRNA or CK-20 mRNA. Positive CEA mRNA was
significantly correlated with tumor size p=0.008), vessel invasion (p=0.001),
depth of tumor invasion (p=0.007), lymph node metastasis (p< 0.001), and TNM
stage (p<0.001). In addition, the multivariate logistic regression
demonstrated that CEA mRNA expression was an independent and significant
predictor for postoperative recurrence/metastasis (p=0.032). Our findings
suggest that CEA mRNA may be a more reliable marker than hTERT, CK-19 and CK-20
for the detection of circulating cancer cells in gastric cancer patients'
peripheral blood. Patients with positive CEA mRNA expression in peripheral
blood have a significantly higher risk of postoperative
recurrence/metastasis.
Keywords: Molecular detection, disseminated tumor cell, gastric cancer, CEA mRNA
