Detection of tumor cell dissemination in pancreatic ductal carcinoma patients by CK 20 RT-PCR indicates poor survival.

Abstract

PURPOSE:

This prospective study evaluates the diagnostic potential of Cytokeratin 20 (CK 20) RT-PCR for the detection of disseminated tumor cells in bone marrow and blood of a large cohort of patients with ductal adenocarcinoma of the pancreas and the prognostic value on overall survival prediction.

METHODS:

Between 1994 and 2003, 172 patients (83 male, 89 female; 13-82 years) with pancreatic ductal adenocarcinoma underwent surgery. Bone marrow samples and venous blood were taken preoperatively and analyzed for disseminated tumor cells by nested CK 20 RT-PCR.

RESULTS:

Disseminated tumor cells were detected in 81 (47.1%) of the 172 patients in the bone marrow and/or the venous blood. Overall, in 45 of the 135 (33.3%) bone marrow samples and in 52 of the 154 (33.8%) blood samples, CK 20 positive cells were detected. Detection rates increased with the UICC-tumor stage. According to Kaplan-Meier, univariate survival analysis of all 172 patients (n = 78 R0-; n = 18 R1- and n = 5 R2-resected; n = 71 palliative surgery) showed a statistically significant relationship of overall survival to radicality of the operation (P < 0.0001), the UICC-stage of the tumors (P = 0.0011) and the detection of disseminated tumor cells in bone marrow and/or venous blood (P = 0.05). Patients with well- and moderately- differentiated tumors (G1 and G2) had a significantly longer survival (P = 0.045) than patients suffering from poorly differentiated tumors (G3). A positive CK 20 status in the bone marrow and/or blood within the group of patients with G1 and G2 tumors had a significantly negative prognostic impact on their survival (P = 0.046).

CONCLUSIONS:

Disseminated tumor cells can be detected in patients with pancreatic ductal adenocarcinoma by CK 20 RT-PCR. Detection rates are stage dependent, and survival analysis demonstrated statistically relevant data. From a clinical point of view, this finding is especially noteworthy for the group of well- and moderately-differentiated tumors.

• Authors: Edlyn Soeth, Urte Grigoleit, Barbara Moellmann, Christian Röder, Bodo Schniewind, Bernd Kremer, Holger Kalthoff, Ilka Vogel
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 131 Issue 10 Pg. 669-76 (Oct 2005) ISSN: 0171-5216 [Print] Germany
• PMID: 16136352 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Intermediate Filament Proteins
• KRT20 protein, human
• Keratin-20

Topics

• Adenocarcinoma (mortality, pathology)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (analysis)
• Bone Marrow Neoplasms (secondary)
• Carcinoma, Pancreatic Ductal (mortality, pathology)
• Female
• Humans
• Intermediate Filament Proteins (metabolism)
• Keratin-20
• Male
• Middle Aged
• Neoplastic Cells, Circulating
• Pancreatic Neoplasms (mortality, pathology)
• Prognosis
• Reverse Transcriptase Polymerase Chain Reaction
• Survival Rate