Disseminated tumour cells as a prognostic biomarker in colorectal cancer

• Published in: British journal of cancer 2011-04, Vol.104 (9), p.1434-1439
• Main Authors: Flatmark, K, Borgen, E, Nesland, J M, Rasmussen, H, Johannessen, H-O, Bukholm, I, Rosales, R, Hårklau, L, Jacobsen, H J, Sandstad, B, Boye, K, Fodstad, Ø
• Format: Article
• Language: English
• Subjects: 692/53/2422; 692/699/67/1504/1885; Adult; Aged; Aged, 80 and over; Analysis of Variance; Antibodies; Antigens, Neoplasm - analysis; Biological and medical sciences; Biomarkers; Biomedical and Life Sciences; Biomedicine; Bone marrow; Bone Marrow - pathology; Cancer Research; Cell Adhesion Molecules - analysis; Colorectal cancer; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Cytokeratin; Disease-Free Survival; Drug Resistance; Epidemiology; Epithelial Cell Adhesion Molecule; Female; Gastroenterology. Liver. Pancreas. Abdomen; Hospitals; Humans; Immunohistochemistry; Immunomagnetic Separation; Kaplan-Meier Estimate; Keratins - analysis; Male; Medical prognosis; Medical research; Medical sciences; Metastasis; Middle Aged; Molecular Diagnostics; Molecular Medicine; Neoplasm Staging; Neoplastic Cells, Circulating - pathology; Norway; Oncology; Patients; Predictive Value of Tests; Prognosis; Prospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Tumors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2011.97

Background: The study was performed to determine detection rate and prognostic relevance of disseminated tumour cells (DTC) in patients receiving curatively intended surgery for colorectal cancer (CRC). Methods: The study population consisted of 235 patients with CRC prospectively recruited from five hospitals in the Oslo region. Bone marrow (BM) aspirates were collected at the time of surgery and the presence of DTC was determined by two immunological methods; immunomagnetic selection (using an anti-EpCAM antibody) and immunocytochemistry (using a pan-cytokeratin antibody). Associations between the presence of DTC and metastasis-free, disease-specific and overall survival were analysed using univariate and multivariate methods. Results: Disseminated tumour cells were detected in 41 (17%) and 28 (12%) of the 235 examined BM samples by immunomagnetic selection and immunocytochemistry, respectively, with only five samples being positive with both methods. The presence of DTC was associated with adverse outcome (metastasis-free, disease-specific and overall survival) in univariate and multivariate analyses. Conclusion: The presence of DTC was associated with adverse prognosis in this cohort of patients curatively resected for CRC, suggesting that DTC detection still holds promise as a biomarker in CRC.