This work proposed a method to assess the occult
micrometastasis characteristic in peri-operative peripheral blood (PB) based on multipoint quantification of multimarker genes by real-time semiquantitative RT-PCR. The expression levels of SCC, CK19, CK20, CEA and
survivin mRNA in PB samples collected before surgery (B-1), immediately after surgery (B0) and at the third day post-operatively (B+3) from 36 squamous
esophageal cancer (EC) patients were detected. SCC and CK19
mRNA showed low positivity detection rates, while the rate for CEA and
survivin mRNA panel was 58.3%, 83.3% and 72.3% at B-1, B0 and B+3, respectively. Opposite to the significant increase and slow decrease of CEA cells at stages of B-1 to B0 and B0 to B+3, respectively,
survivin cells decreased significantly and increased quickly at the two stages. The follow-up with a period of 1.2 years showed that the patients with the B+3/B0 ratios of >or= 0.3 for CEA cells or/and >or= 10 for
survivin cells exhibited significantly high possibility of developed
metastasis, and the sensitivity to predict developed
metastasis increased from 54.5% of CEA
mRNA alone to 72.7% of CEA and
survivin mRNA panel. These results suggested that CEA and
survivin gene panel improved the sensitivity to predict recurrence and differentiate the micrometastatic process.