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BACKGROUND/AIMS: Peritoneal micrometastasis is known to play an important role in the recurrence of gastric cancer. However, its effects remain equivocal. Herein, we examine the messenger RNA (mRNA) as tumor markers, carcinoembryonic antigen (CEA), and cytokeratin 20 (CK20), in peritoneal washing fluid. Moreover, we evaluate whether these results could predict the recurrence of gastric cancer following curative resection. METHODS: We prospectively enrolled 132 patients with gastric cancers, who had received an operation, between January 2010 and January 2013. The peritoneal lavage fluid was collected at the operation field and semi-quantitative PCR was performed using the primers for CEA and CK20. We excluded patients with stage IA (n=28) early gastric cancer, positive cytologic examination of peritoneal washings (n=7), and those who were lost during follow up (n=18). RESULTS: A total of 79 patients with gastric cancers were enrolled, and the mean follow-up period was 39.95±19.25 months (range, 5-72 months). According to the multivariate analysis, T4 stage at the initial diagnosis was significantly associated with recurrence. All cases of recurrence were CEA positive and 6 cases were CK20 positive. The positive and negative predictive values of CEA were 32.0% and 100%, respectively, whereas those of CK20 were 37.5% and 71.4%, respectively. Disease free survival of CK20-negative cases was 36.17±20.28 months and that of CK20-positive cases was 32.06±22.95 months (p=0.39). CONCLUSIONS: It is unlikely that the real time polymerase chain reaction results of mRNA for CEA and CK20 in peritoneal washing fluid can predict recurrence. However, negative results can convince surgeons to perform curative R0 resection.
Subject(s)
Humans , Biomarkers, Tumor , Carcinoembryonic Antigen , Diagnosis , Disease-Free Survival , Follow-Up Studies , Keratin-20 , Keratins , Multivariate Analysis , Neoplasm Micrometastasis , Peritoneal Lavage , Polymerase Chain Reaction , Prospective Studies , Real-Time Polymerase Chain Reaction , Recurrence , RNA, Messenger , Stomach Neoplasms , SurgeonsABSTRACT
Thymic carcinomas are uncommon malignant tumors, and thymic adenocarcinomas are extremely rare. Here, we describe a case of primary thymic adenocarcinoma in a 59-year-old woman. Histological examination of the tumor revealed tubular morphology with expression of cytokeratin 20 and caudal-type homeobox 2 according to immunohistochemistry, suggesting enteric features. Extensive clinical and radiological studies excluded the possibility of an extrathymic primary tumor. A review of the literature revealed only two global cases of primary tubular adenocarcinomas of the thymus with enteric immunophenotype.
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , Genes, Homeobox , Immunohistochemistry , Keratin-20 , Thymoma , Thymus GlandABSTRACT
Objective To explore the clinical value of expression of CEA and CK-20 detected by flow cytometry (FCM) in peritoneal washes on predicting peritoneal metastasis and prognosis of gastric carcinama.Methods Clinicopathological characteristics and follow up data of 105 patients with gastric carcinoma who were underwent D2 radical resection (R0) were collected.Peritoneal washes was collected.Peritoneal lavage cytology examination (PLC) was used to find intraperitoneal free cancer cells (IFCC).FCM was used to determine the CEA and CK-20 expressions.Meanwhile,13 patients with benign lesion on the stomach and the gastric carcinama cell line SGC-7901 were served as the negative and positive control,respectively.Results Positive expression of CEA was in 48 (45.7 ％) patients,of CK-20 was found in 67 (63.8 ％) patients,and of CEA and CK-20 was in 85 (81.0 ％) patients by FCM.However,positive expression of IFCCs was found in 31 patients(29.5 ％) by PLC.The expression of CEA and CK-20 were related to serosa invasion,lymphnode metastasis and pTNM stage (P ＜ 0.05).The median survival of patients with negative expression of both CEA and CK-20 (n =20) was significantly longer those with positive expression (n =30)(52 vs 18 months,P ＜ 0.05).Conclusions Combined Detection of CEA and CK-20 in peritoneal washes by FCM can be used to predict peritoneal micrometastasis and may predict the prognosis of gastric carcinoma.
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Objective To explore the expressions of CK20, S100A7 and substance P (SP) in different stages of psoriatic lesions and their relationship. Methods A total of 19 patients, who had received irregular treatment for psoriasis and had both progressive and healed psoriatic lesions, were enrolled in this study. Skin tissue specimens were obtained from perilesional normal skin, progressive lesions and healed lesions of these patients and subjected to immunohistochemical analysis of expressions of CK20, S100A7 and SP. Results The relative expression level (absorbance value obtained from immunohistochemical analysis) was 7683.80 ± 6134.55,18305.04 ± 13171.30, 7257.53 ± 4417.75 for CK20, 8789.05 ± 6240.91, 18058.01 ± 16537.18, 9295.65 ±9310.02 for S100A7, 3242.51 ± 3775.41, 9364.98 ± 7596.64, 2910.85 ± 3349.46 for SP, respectively, in normal skin, progressive lesions and healed psoriatic lesions. A significant increase was observed in the expressions of CK20, S100A7 and SP in progressive lesions compared with normal skin and healed lesions, whereas no statistical difference was noted in those between normal skin and healed lesions (P ＞ 0.05 ). The expression of CK20 was positively correlated with that of S100A7 and SP (r = 0.779, 0.876, both P ＜ 0.05 ). Conclusion The pathogenesis of psoriasis seems to be associated with the changes in the number of Merkel cells.
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Objective To examine the frequency and mode of distal spread of low and middle rectal cancer in the mesorectum and rectal wall. Methods Thirty-four specimens from low and middle rectal cancer were collected between August 2004 and December 2005 in Cancer Center of Sun Yat-sen University. Twenty-eight specimens of low and middle rectal cancer were collected between October 2006 and October 2007 in Shandong Provincial Hospital of Shandong University. All 62 specimens were studied using large slices stained with CK20. Logistic regression was used to analyze clinicopathologic factors related to distal spread of low and middle rectal cancer in the mesorectum and rectal wall. Results Two types of distal spread of the tumor were observed in rectal wall: submucosa invasion and muscularis propria invasion. Distal spread in rectal wall was observed in 16% (10/62) of the patients. The length of distal spread in rectal wall was found from O. 5 cm to 1.0 cm. Four types of distal spread of the tumor were observed in mesorectum: lymph node invasion, blood and lymphatic vessel invasion, perineural invasion, isolated neoplastic microfoci. Distal spread in mesorectum was observed in 24% (15/62) of the patients. The length of distal spread in mesorectum was found from 0. 5 cm to 4. 0 cm. Three more cases with microcapillary invasion in distal mesorectum was observed by immunohistochemical technique, which was difficult to identify by conventional HE staining. Univariate analysis showed that serum CEA , lymph node invasion, CMI and TNM stage were correlated with distal spread of low and middle rectal cancer in the mesorectum and rectal wall. TNM stage was shown to be independent impact factor by multivariate analysis( Wald = 9. 567, P =0. 002). Conclusion TNM stage is an independent impact factor for distal spread of low and middle rectal cancer in the mesorectum and rectal wall. Resection of 1.5 cm for distal rectal wall is necessary for a curative intention, but it must be emphasized that the clearance for distal mesorectum should be 5 cm at least.
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Objective To establish reverse transcriptase-polymerase chain reaction(RT-PCR) with primers specific for CEA gene and CK20 gene to detect circulating tumor cells in peripheral blood of esophageal cancer pa-tients,and try to find the relationship between the mRNA expression and micrometastasis. Methods The expressions of CEA,CK20 were analyzed by RT-PCR in 53 cases of esophageal tumor tissue and in peripheral blood,compared with 10 patients with benign esophageal disease and 20 healthy volunteers. Results The expressions of CEA-mRNA, CK20-mRNA were 96.23% (51/53), 100% ( 53/53 ) in 53 esophageal tumor tissue and were 52.83% (28/53), 49.06% (26/53) in peripheral blood of 53 esophageal cancer patients. In control group,there was only one expression of CEA-mRNA in peripheral blood of 10 patients with benign esophageal disease,as well as in 20 healthy volunteers. There was no expression of CK20-mRNA in peripheral blood of 10 patients with benign esophageal disease and 20 healthy volunteers. Conclusion CEA-mRNA, CK20-mRNA might be specific and sensitive markers to detect circu-lating tumor cells in peripheral blood and their expression was closely related to TNM stages of the esophageal cancer patients.
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Background: Colorectal cancer relapses or metastasizes in 30 percent of cases. Cytokeratin 20 is present in 95 percent of colorectal tumors and their metastases and could be used as a marker to detect tumor cells. Aim: To assess the usefulness and prognostic value of peripheral blood and bone marrow cytokeratin 20 determinations in patients with colorectal cancer. Material and methods: Blood and bone marrow samples were obtained from 56 patients with colorectal cancer aged 26 to 77 years (31 females) before surgical procedure. They were followed for a mean of 22 months (range 2.9 to 72 months) after surgery. Blood and bone marrow from 45 patients without cancer and 35 healthy subjects were used as negative controls. Messenger RNA expression of cytokeratin 20 was studied by real time and nested polymerase chain reaction. Results: Cytokeratin 20 was detected in 6 percent of controls and 41 percent of patients. There was no relation between cytokeratin 20 expression and age, gender, overall survival, tumor relapse, progression, localization or stage. Conclusions: Cytokeratin 20 determination is not useful as a marker of tumor progression or dissemination in patients with colorectal cancer.