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Detection of Carcinoembryonic Antigen Messenger RNA–Expressing Cells in Portal and Peripheral Blood During Surgery Does Not Influence Relapse in Colorectal Cancer

¹ Department of Surgery, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, 259-1193, Japan
² Department of Radiology, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa, 259-1193, Japan

Correspondence: Address correspondence and reprint requests to: Sotaro Sadahiro, MD; E-mail: sadahiro{at}is.icc.u-tokai.ac.jp

Background: No consensus has been reached on whether cancer cells detected in blood during colorectal cancer (CRC) surgery may serve as a prognostic indicator.

Methods: One hundred patients with CRC who underwent curative surgery were the subjects. Portal and peripheral blood were collected immediately after celiotomy and examined for carcinoembryonic antigen (CEA) messenger RNA (mRNA) by using competitive seminested reverse transcriptase-polymerase chain reaction. The median follow-up period was 59 months (range, 49–74 months).

Results: Until now, recurrence has been confirmed in 13 patients (13%). The 4-year recurrence rate was 6.7% (3 of 45) in patients with CEA mRNA–positive portal blood and 20.8% (10 of 48) in patients with CEA mRNA–negative portal blood (P = .09); it was 5.6% (2 of 36) and 19.3% (11 of 57) in patients with CEA mRNA– positive peripheral blood and CEA mRNA– negative blood, respectively (P = .12). There was no difference in disease-free survival between the CEA mRNA– positive and – negative groups. The multivariate analysis showed that the presence of tumor cells in portal or peripheral blood was a factor that reduced recurrence. The relative risks were .17 (P = .01) for the portal vein and .24 (P = .07) for the peripheral vein.

Conclusions: The detection of cancer cells in blood taken during surgery is not considered to be a poor-prognostic factor in CRC.

Key Words: Colorectal cancer • Carcinoembryonic antigen • Circulating cancer cells • Reverse transcriptase-polymerase chain reaction

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