Intrinsic variability in the detection of micrometastases in lymph nodes for re-staging of colorectal cancer. effect of individual markers and tissue samples

Eur J Cancer. 2003 Jun;39(9):1234-41. doi: 10.1016/s0959-8049(03)00231-4.

Abstract

In this study, we investigated whether (a) carcinoembryonic antigen (CEA), cytokeratin-20 (CK-20) and guanylyl cyclase C (GCC) are clinically useful markers for the molecular detection of submicroscopic metastases in colorectal cancer (CRC) and (b) whether overexpression of CEA, CK-20 and GCC can be reliably detected in formalin-fixed, paraffin-embedded tissues as well as frozen lymph nodes. We studied 175 frozen lymph nodes and 158 formalin-fixed, paraffin-embedded lymph nodes from 28 cases of CRC. CEA or CK-20 or GCC-specific polymerase chain reaction (PCR) was carried out on mRNA transcripts extracted from the nodal tissues. Ten out of 11 Dukes' B CRC cases had detectable CEA and CK-20 while 6 out of 11 Dukes' B CRC cases had detectable GCC. In general, the difference of re-staged cases when comparing frozen and paraffin-embedded samples was marked; the only statistically significant correlation between frozen and paraffin tissue was for the CEA marker. Our results indicated a high incidence (>50%) of detecting micrometastases in histologically-negative lymph nodes at the molecular level.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Carcinoembryonic Antigen / analysis
  • Colorectal Neoplasms / chemistry*
  • Colorectal Neoplasms / pathology*
  • Female
  • Guanylate Cyclase / analysis
  • Humans
  • Intermediate Filament Proteins / analysis
  • Keratin-20
  • Lymphatic Metastasis / pathology*
  • Male
  • Middle Aged
  • Neoplasm Staging / methods*
  • Reverse Transcriptase Polymerase Chain Reaction / methods
  • Tumor Cells, Cultured

Substances

  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Intermediate Filament Proteins
  • KRT20 protein, human
  • Keratin-20
  • Guanylate Cyclase