Affiliations: II. Department of Medicine, Semmelweis University,
1088 Budapest, Hungary
Note: [] Corresponding author: Bela Molnar, M.D., Ph.D, II. Department of
Medicine, Szentkirályi Str. 46, 1088 Budapest, Hungary. Tel.: +36 209
581499; Fax: +36 1 2660816; E-mail: mb@bel2.sote.hu
Abstract: Aims: Cytokeratin(CK) based real-time RT-PCR assays (QRT-PCR) are
now available for peripheral blood circulating tumor cell (CTC) evaluations in
colorectal cancer(CRC) patients. Results are non-existent for the application
of these techniques to the determination of progression and therapy response in
Dukes stage D CRC patients. Patients and methods: Each month 30~ml
peripheral blood of 30 Dukes D patients (17 with progression) were drawn. CEA,
CA19-9, CA72-A and TPA-M determinations were made. CK20, thymidilate
synthase(TS) QRT-PCR was performed, as well. Buffy coat was used for
immunmagnetic cancer cell isolation and CTC counting. Correlation between
elevated CTC and macroscopic progression within 3 months was determined by
Chi^{2} test. Results: Microscopic CTC single cell, doublet, cluster
number were found in correlation with CK20 QRT-PCR results (p< 0.01).
There was a significant increase in microscopic CTC number, CK20 and decrease
in TS QRT-PCR levels (p< 0.05) in the peripheral blood of the
non-responder as compared to responder patients. Elevation of the CTC was in
significant correlation with macroscopic progression of the disease in 3 months
(p< 0.01). Conclusions: CTC number reflects the chemotherapeutic
sensitivity of CRC patients. Elevation of circulating tumor cell number in
peripheral blood is in correlation with macroscopic progression.
