RESUMEN
<p><b>OBJECTIVE</b>To elucidate the significance of detecting cytokeratin gene (CK-20 mRNA) expression in metastatic lymph nodes of colon carcinoma patients.</p><p><b>METHODS</b>The expression of CK-20 mRNA was detected in 342 lymph nodes by reverse transcription-polymerase chain reaction (RT-PCR) in 49 colon carcinoma patients. Its incidence was compared with that by routine pathologic examination.</p><p><b>RESULTS</b>The positive rates of detecting metastasis in the lymph nodes were 21.9% by RT-PCR and 11.1% by routine pathologic examination.</p><p><b>CONCLUSION</b>The detection of cancer metastasis in the lymph nodes in colon carcinoma is almost doubled (21.9% vs 11.1%) by CK-20 mRNA, which may provide a guiding significance in staging, treatment planning and prognosis in the prognostic estimation of colon carcinoma patients.</p>
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias del Colon , Diagnóstico , Genética , Patología , Expresión Génica , Marcadores Genéticos , Genética , Proteínas de Filamentos Intermediarios , Genética , Queratina-20 , Metástasis Linfática , Diagnóstico , Estadificación de Neoplasias , Pronóstico , ARN Mensajero , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
<p><b>OBJECTIVE</b>To detect occult metastases in lymph nodes from patients with colorectal carcinoma and its clinical significance.</p><p><b>METHODS</b>The metastases in 260 lymph nodes from 39 histologically verified colorectal cancer patients were studied by both hematoxylin-eosin (HE) staining and cytokeratin-20 (CK20) specific RT-PCR. Ten normal lymph nodes were served as negative controls, and HT29 colon cancer cell line and 5 colorectal cancer specimens as positive controls.</p><p><b>RESULTS</b>Ten normal lymph nodes were CK20-negative, HT29 cells and 5 tumor specimens were all CK20-positive. All 29 lymph nodes from 16 patients which confirmed metastases by HE staining exhibited CK20 positive expression; an additional 28 lymph nodes from 5 patients with no histologically detectable metastases expressed CK20 mRNA, i.e. presence of metastases. The difference of the positivity was significant (11.1% vs 21.9%, P < 0.01). According to the HE staining, the cases of Dukes' A, B, C and D were 3, 20, 12 and 4, respectively. In the 20 patients of Dukes' B stage, 5 of them had CK20-positive lymph nodes.</p><p><b>CONCLUSION</b>CK20-specific RT-PCR is a highly sensitive, specific and simple method for detecting occult metastases in lymph nodes. The detection of CK20 mRNA expression in lymph nodes is recommended to precisely determine tumor stage and postoperative adjuvant therapy for patients with colorectal cancer, and further studies should be done in future to confirm the findings.</p>