Impact of endoscopic stent insertion on detection of viable circulating tumor cells from obstructive colorectal cancer

The placement of a self-expanding metallic stent (SEMS) in obstructive colorectal cancer (OCRC) is acknowledged to be a safe and effective procedure for the relief of obstruction. However, there is concern that shear forces acting on the tumor during stent expansion may release cancer cells into the...

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Bibliographic Details
Published in:Oncology letters 2018-01, Vol.15 (1), p.400-406
Main Authors: Yamashita, Shinya, Tanemura, Masahiro, Sawada, Genta, Moon, Jeongho, Shimizu, Yosuke, Yamaguchi, Toshiki, Kuwai, Toshio, Urata, Yasuo, Kuraoka, Kazuya, Hatanaka, Nobutaka, Yamashita, Yoshinori, Taniyama, Kiyomi
Format: Article
Language:English
Subjects:
Adenoviruses
Antigens
Blood
Care and treatment
Colorectal cancer
Development and progression
FDA approval
Health aspects
Intestinal obstruction
Laparoscopy
Medical prognosis
Metastasis
Oncology
Ostomy
Stents
Surgery
Surgical outcomes
Telomerase
Tumors
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Summary:The placement of a self-expanding metallic stent (SEMS) in obstructive colorectal cancer (OCRC) is acknowledged to be a safe and effective procedure for the relief of obstruction. However, there is concern that shear forces acting on the tumor during stent expansion may release cancer cells into the circulation, resulting in a poor prognosis. The aim of the present study was to determine whether colonic stent insertion increases viable circulating tumor cells (v-CTCs). A telomerase-specific replication-selective adenovirus-expressing GFP (TelomeScanF35) detection system was used to detect v-CTCs in 8 OCRC patients with a SEMS before and after stent insertion and after surgical resection. In 7 patients, a SEMS was inserted as a bridge to surgery (BTS), and in one patient, a SEMS was inserted for palliation. Surgical resection (R0) was performed in 7 patients. Four patients had no v-CTCs before SEMS placement, two of four measurable patients had an increased number of v-CTCs after SEMS placement (1-3 v-CTCs), and one of two patients with increased v-CTCs developed distant lymphatic metastasis despite curative resection. Four patients had v-CTCs (1-19 cells) before SEMS placement, and two of these four patients had an increase in the number of v-CTCs (20-21 cells) after SEMS placement, while one of the four patients died early with distant metastasis. The present study demonstrated that endoscopic stent insertion for OCRC may result in tumor cell dissemination into the peripheral circulation and may induce distant metastases.
ISSN:1792-1074
1792-1082
DOI:10.3892/ol.2017.7339