Identifying patients with an unfavorable prognosis in early stages of colorectal carcinoma

• Published in: Oncotarget Vol. 9; no. 44; pp. 27423 - 27434
• Main Authors: Hendricks, Alexander, Eggebrecht, Greta-Lou, Bernsmeier, Alexander, Geisen, Reinhild, Dall, Katharina, Trauzold, Anna, Becker, Thomas, Kalthoff, Holger, Schafmayer, Clemens, Röder, Christian, Hinz, Sebastian
• Format: Journal Article
• Language: English
• Published: United States Impact Journals LLC 08.06.2018
• Subjects: Research Paper; prognostic marker; colorectal cancer; cytokeratin 20; circulating tumor cells; liquid biopsy
• ISSN: 1949-2553; 1949-2553
• DOI: 10.18632/oncotarget.25384

In recent years, the concept of liquid biopsy diagnostics in detection and progress monitoring of malignant diseases gained significant awareness. We here report on a semi-quantitative real-time cytokeratin 20 RT-PCR-based assay, for detecting circulating tumor cells within a fraction of peripheral blood mononuclear cells in colorectal cancer patients. In total, 381 patients were included. Prior to surgical tumor resection, a peripheral blood sample was drawn. Mononuclear cells were isolated by Ficoll centrifugation and a cytokeratin 20 qRT-PCR assay was performed. Quantitative PCR data was assessed regarding histopathological characteristics and patients´ clinical outcome. A cut-off value was determined at ≥ 2.77 [EU]. Stratifying patients by this cut-off, it represents a statistically highly significant prognostic marker for both the overall and disease-free survival in the entire cohort UICC I-IV (both p<0.001) and in early tumor stages UICC I+II (overall survival p=0.003 and disease-free survival p=0.005). In multivariate analysis, the cut-off value stands for an independent predictor of significantly worse overall and disease-free survival (p=0.035 and p=0.047, respectively). We successfully established a highly sensitive real-time qRT-PCR assay by which we are able to identify colorectal cancer patients at risk for an unfavorable prognosis in UICC I and II stages.