Carcinoembryonic Antigen Messenger RNA Expression Using Nested Reverse Transcription-PCR in the Peripheral Blood During Follow-up Period of Patients Who Underwent Curative Surgery for Biliary-Pancreatic Cancer

Abstract

Purpose: Outcome for patients with biliary-pancreatic cancer is still poor, despite curative operation. We investigated the clinical significance of molecular detection of circulating cancer cells in the blood as an early indicator of relapse during follow-up of patients who underwent a curative operation for biliary-pancreatic cancer.Patients and Methods: We followed 53 patients who underwent a curative operation for biliary-pancreatic cancer between 1996 and 2001. We used reverse transcription-PCR in the peripheral blood to evaluate carcinoembryonic antigen (CEA) mRNA expression for molecular detection of circulating cancer cells. Follow-up examinations every 3 months after surgery included CEA mRNA expression in the blood, serum CEA, serum carbohydrate antigen 19-9 (CA19-9), and computed tomography or magnetic resonance imaging.Results: Sixteen of 53 patients (30.2%) were diagnosed with a recurrence by imaging studies. The CEA mRNA detection rate in the peripheral blood of these 16 patients was 75% compared with 5.4% in the 37 patients without relapse (P < 0.001). Sensitivity of CEA mRNA, CEA, and CA19-9 serum levels was 75.0%, 50.0%, and 68.8%, respectively. Similarly, specificity was 94.6%, 64.9%, and 81.1%, respectively. CEA mRNA was expressed in the blood, even though tumor markers CEA and CA19-9 were within the normal range in patients with relapse. CEA mRNA expression in the blood, as well as the serum level of CA19-9, tended to be detected a few months earlier than detection by imaging modalities.Conclusions: During the follow-up of patients who undergo a curative operation for biliary-pancreatic cancer, CEA mRNA expression in the peripheral blood might be a useful and early indicator of relapse.

Carcinoembryonic Antigen Messenger RNA Expression in Blood Predicts Recurrence in Esophageal Cancer

“…Mataki et al (33) reported the longitudinal analysis of CEA mRNA expression and two tumor markers, serum CEA and serum carbohydrate antigen 19-9, and found that CEA mRNA was expressed in two recurrent cases without tumor marker Fig. 1.…”

B7‐H3 expression in gastric cancer: A novel molecular blood marker for detecting circulating tumor cells

“…(12,13) The RT-PCR is a useful assay for detecting circulating tumor cells (CTC) within blood specimens from patients with various malignancies, including gastric cancer. (14)(15)(16)(17)(18) We reported that the presence of CTC correlates with tumor progression and outcomes of patients with esophageal, gastric and biliary-pancreatic cancer.…”

“…(12,13) The RT-PCR is a useful assay for detecting circulating tumor cells (CTC) within blood specimens from patients with various malignancies, including gastric cancer. (14)(15)(16)(17)(18) We reported that the presence of CTC correlates with tumor progression and outcomes of patients with esophageal, gastric and biliary-pancreatic cancer. (14)(15)(16)(17)(18) Several epithelial-specific antigens such as CEA, cytokeratin-19, and cytokeratin-20, have been used generally in many studies of CTC detection in gastric cancer.…”

“…(14)(15)(16)(17)(18) We reported that the presence of CTC correlates with tumor progression and outcomes of patients with esophageal, gastric and biliary-pancreatic cancer. (14)(15)(16)(17)(18) Several epithelial-specific antigens such as CEA, cytokeratin-19, and cytokeratin-20, have been used generally in many studies of CTC detection in gastric cancer. (15,19) However, recent studies have found false-positive results in RT-PCR assays using these markers for CTC detection.…”

Detection of isolated tumour cells in the blood and bone marrow of patients with gastric cancer by combined sorting, isolation and determination of MAGE-1, -2 mRNA expression

“…These included immunocytochemistry with the use of antibodies for different tumour markers, although they are not tumourspecific (7). In conjunction with the antibody staining techniques, reverse transcriptase polymerase chain reaction (RT-PCR) was introduced as a powerful method for further analysis of potentially micrometastasizing tumour cells (8)(9)(10)(11)(12). This highly sensitive technique was designed for the detection of mRNA of presumptive tumour markers (13)(14)(15)(16)(17).…”