The expression of carcinoembryonic antigen mRNA in the lavage of the dissected area of the lateral lymph nodes influences the lateral recurrence of lower rectal cancer.
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
/ genetics
Carcinoembryonic Antigen
/ genetics
Female
Follow-Up Studies
Gene Expression
Humans
Lymph Node Excision
Lymph Nodes
/ metabolism
Male
Middle Aged
Neoplasm Recurrence, Local
/ diagnosis
Neoplasm, Residual
/ diagnosis
Prognosis
RNA, Messenger
/ genetics
Rectal Neoplasms
/ diagnosis
Therapeutic Irrigation
Carcinoembryonic antigen mRNA
Lateral lymph node dissection
Lateral recurrence
Rectal cancer
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
30
07
2020
accepted:
12
04
2021
pubmed:
8
10
2021
medline:
2
2
2022
entrez:
7
10
2021
Statut:
ppublish
Résumé
To determine whether or not migrating cancer cells are present on the surgical plane after lateral lymph node dissection (LLND) for lower rectal cancer and related to lateral recurrence (LR), we evaluated the lavage of LLND areas by reverse-transcription polymerase chain reaction (RT-PCR) to check the expression of CEA mRNA in the residual cancer cells. Thirty patients who underwent curative LLND were enrolled. Lavage was collected after LLND and subjected to RT-PCR to detect CEA mRNA. The median follow-up to check for recurrence was 31.4 months. CEA mRNA was detected in 9 of the 46 dissected areas. Based on the receiver operating characteristic curves, the cut-off value of PCR was set at 0.025. This cut-off point classified five patients into the high-expression group for CEA mRNA. During follow-up, LR developed in 1 of 40 low-expression areas of CEA mRNA and 3 of 6 high-expression areas. The LR rate was higher in the high-expression group than in the low-expression group (p = 0.015). A multivariate analysis showed that the high expression of CEA mRNA was likely an independent prognostic factor of LR. The expression of CEA mRNA in the lavage of LLND areas indicates the presence of residual cancer cells that cause LR.
Identifiants
pubmed: 34617146
doi: 10.1007/s00595-021-02347-w
pii: 10.1007/s00595-021-02347-w
doi:
Substances chimiques
Biomarkers, Tumor
0
Carcinoembryonic Antigen
0
RNA, Messenger
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
84-91Informations de copyright
© 2021. Springer Nature Singapore Pte Ltd.
Références
Miles WE. The pathology of the spread of cancer of the rectum, and its bearing upon the surgery of the cancerous rectum. Surg Gynecol Obstet. 1931;52(350):1931–2359.
Coller FA, Kay EB, MacIntyre RS. Regional lymphatic metastasis of carcinoma of the rectum. Surgery. 1940;8(2):294–311.
Grinnell RS. The lymphatic and venous spread of carcinoma of the rectum. Ann Surg. 1942;116(2):200.
doi: 10.1097/00000658-194208000-00005
Deddish MR. Abdominopelvic lymph-node dissection in cancer of the rectum and distal colon. Cancer. 1951;4(6):1364–6.
doi: 10.1002/1097-0142(195111)4:6<1364::AID-CNCR2820040618>3.0.CO;2-M
Sauer I, Bacon HE. Influence of lateral spread of cancer of the rectum on radicability of operation and prognosis. Am J Surg. 1951;81(1):111–20.
doi: 10.1016/0002-9610(51)90196-1
Gilchrist RK, David VC. Lymphatic spread of carcinoma of the rectum. Ann Surg. 1938;108(4):621.
doi: 10.1097/00000658-193810000-00011
Ueno M, Oya M, Azekura K, Yamaguchi T, Muto T. Incidence and prognostic significance of lateral lymph node metastasis in patients with advanced low rectal cancer. Br J Surg. 2005;92(6):756–63.
doi: 10.1002/bjs.4975
Koyama Y, Moriya Y, Hojo K. Effects of extended systematic lymphadenectomy for adenocarcinoma of the rectum—significant improvement of survival rate and decrease of local recurrence. Jpn J Clin Oncol. 1984;14(4):623–32.
pubmed: 6520971
Watanabe T, Muro K, Ajioka Y, Hashiguchi Y, Ito Y, Saito Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol. 2018;23(1):1–34.
doi: 10.1007/s10147-017-1101-6
Kusters M, van de Velde CJ, Beets-Tan RG, Akasu T, Fujita S, Yamamoto S, et al. Patterns of local recurrence in rectal cancer: a single-center experience. Ann Surg Oncol. 2009;16(2):289–96.
doi: 10.1245/s10434-008-0223-5
Stearns MW Jr, Deddish MR. Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum. Dis Colon Rectum. 1959;2(2):169–72.
doi: 10.1007/BF02616711
Heald R, Husband E, Ryall R. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg. 1982;69(10):613–6.
doi: 10.1002/bjs.1800691019
Enker WE, Thaler HT, Cranor ML, Polyak T. Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg. 1995;181(4):335–46.
pubmed: 7551328
Benson AIB, Venook A, Cederquist L, Chan E, Chen Y, Cooper H, et al. Colon cancer, version 1.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15(3):370–98.
doi: 10.6004/jnccn.2017.0036
West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P. Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol. 2010;28(2):272–8.
doi: 10.1200/JCO.2009.24.1448
Murono K, Ishihara S, Kawai K, Kaneko M, Sasaki K, Otani K, et al. Significance of carcinoembryonic antigen mRNA in peritoneal lavage determined by transcription-reverse transcription concerted method in patients with low rectal cancer. Asian J Surg. 2018;41(4):321–7.
doi: 10.1016/j.asjsur.2017.01.004
Hara M, Nakanishi H, Jun Q, Kanemitsu Y, Ito S, Mochizuki Y, et al. Comparative analysis of intraperitoneal minimal free cancer cells between colorectal and gastric cancer patients using quantitative RT-PCR: possible reason for rare peritoneal recurrence in colorectal cancer. Clin Exp Metastasis. 2007;24(3):179–89.
doi: 10.1007/s10585-007-9067-9
Hara M, Hirai T, Nakanishi H, Kanemitsu Y, Komori K, Tatematsu M, et al. Isolated tumor cell in lateral lymph node has no influences on the prognosis of rectal cancer patients. Int J Colorectal Dis. 2007;22(8):911–7.
doi: 10.1007/s00384-007-0280-4
Matsumoto T, Ohue M, Sekimoto M, Yamamoto H, Ikeda M, Monden M. Feasibility of autonomic nerve-preserving surgery for advanced rectal cancer based on analysis of micrometastases. Br J Surg. 2005;92(11):1444–8.
doi: 10.1002/bjs.5141
Moriya Y, Sugihara K, Akasu T, Fujita S. Importance of extended lymphadenectomy with lateral node dissection for advanced lower rectal cancer. World J Surg. 1997;21(7):728–32.
doi: 10.1007/s002689900298
Ueno H, Mochizuki H, Hashiguchi Y, Hase K. Prognostic determinants of patients with lateral nodal involvement by rectal cancer. Ann Surg. 2001;234(2):190.
doi: 10.1097/00000658-200108000-00008
Georgiou P, Tan E, Gouvas N, Antoniou A, Brown G, Nicholls RJ, et al. Extended lymphadenectomy versus conventional surgery for rectal cancer: a meta-analysis. Lancet Oncol. 2009;10(11):1053–62.
doi: 10.1016/S1470-2045(09)70224-4
Hida J-I, Yasutomi M, Fujimoto K, Maruyama T, Okuno K, Shindo K. Does lateral lymph node dissection improve survival in rectal carcinoma? Examination of node metastases by the clearing method. J Am Coll Surg. 1997;184(5):475–80.
pubmed: 9145067
Hojo K, Sawada T, Moriya Y. An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy. Dis Colon Rectum. 1989;32(2):128–33.
doi: 10.1007/BF02553825
Kodera Y, Nakanishi H, Ito S, Yamamura Y, Kanemitsu Y, Shimizu Y, et al. Quantitative detection of disseminated free cancer cells in peritoneal washes with real-time reverse transcriptase-polymerase chain reaction: a sensitive predictor of outcome for patients with gastric carcinoma. Ann Surg. 2002;235(4):499–506.
doi: 10.1097/00000658-200204000-00007
Sato H, Maeda K, Maruta M. Prognostic significance of lateral lymph node dissection in node positive low rectal carcinoma. Int J Colorectal Dis. 2011;26(7):881–9.
doi: 10.1007/s00384-011-1170-3
Okamura R, Hida K, Hasegawa S, Sakai Y, Hamada M, Yasui M, et al. Impact of intraoperative blood loss on morbidity and survival after radical surgery for colorectal cancer patients aged 80 years or older. Int J Colorectal Dis. 2016;31:327–34.
doi: 10.1007/s00384-015-2405-5
Egenvall M, Morner M, Pahlman L, Gunnarsson U. Degree of blood loss during surgery for rectal cancer: a population-based epidemiologic study of surgical complications and survival. Colorectal Dis. 2014;16:696–702.
doi: 10.1111/codi.12630
Morner M, Gunnarsson U, Jestin P, Egenvall M. Volume of blood loss during surgery for colon cancer is a risk determinant for future small bowel obstruction caused by recurrence—a population-based epidemiological study. Langenbecks Arch Surg. 2015;400:599–607.
doi: 10.1007/s00423-015-1317-8
Suto T, Sato T, Iizawa H. Histopathological characteristics of lateral lymph nodes dictate local or distant metastasis and prognosis in low rectal cancer patients. J Anus Rectum Colon. 2018;2(3):90–6.
doi: 10.23922/jarc.2017-047
Inoue Y, Saigusa S, Hiro J, Toiyama Y, Araki T, Tanaka K, et al. Clinical significance of enlarged lateral pelvic lymph nodes before and after preoperative chemoradiotherapy for rectal cancer. Mol Clin Oncol. 2016;4(6):994–1002.
doi: 10.3892/mco.2016.855