Abstract
We analyzed the peripheral blood of patients with gastrointestinal tract cancer
at different stages to assess the presence of carcinoembryonic antigen (CEA)
mRNA by reverse transcriptase-polymerase chain reaction (RT-PCR), which we used
as an indicator for micrometastatic malignant cells. A total of 35 gastric, 24
colorectal, 4 esophageal and 4 biliary tract cancer patients and nine normal
healthy subjects were studied. No CEA mRNA was detected in the nine normal
healthy volunteers. CEA mRNA was detected in 100% (10/10) of metastatic, 33.3%
(3/9) of early gastric cancer (EGC), and 18.8% (3/16) resectable gastric cancer
patients, respectively. In colorectal cancer, 55.6% (5/9) of metastatic cancers
were positive for CEA mRNA, and 26.7% (4/15) Duke stage B/C showed positive. One
patient with stage III gastric cancer who was negative CEA mRNA initially and
turned positive during follow-up, developed multiple bone metastasis one month
later. Another stage III patient, who was positive for CEA mRNA, preoperatively
revealed early relapse in two months. These results suggest that the
identification of circulating tumor cells using RT-PCR for the detection of CEA
mRNA is feasible and this analysis may be a promising tool for early detection
of micrometastatic circulating malignant cells in patients with gastrointestinal
tract cancer.