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Disease Markers
Volume 22, Issue 3, Pages 103-109

Molecular Detection of Disseminated Tumor Cells in the Peripheral Blood of Patients with Gastric Cancer: Evaluation of Their Prognostic Significance

C. H. Wu,1 S. R. Lin,1 J. S. Hsieh,2 F. M. Chen,1,2 C. Y. Lu,3 F. J. Yu,3 T. L. Cheng,4 T. J. Huang,2 S. Y. Huang,5 and J. Y. Wang1,2

1MedicoGenomic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
2Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
3Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
4School of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
5Asia Hepato Gene Co., Ltd., Kaohsiung, Taiwan

Received 29 May 2006; Accepted 29 May 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Early detection of disseminated tumor cells in the peripheral blood of patients with early stage gastric cancer could help to improve the outcome after tumor resection. The aim of this study is to evaluate the prognostic significance of tumor-related mRNA for the detection of circulating tumor cells in gastric cancer patients by a reverse-transcriptase polymerase chain reaction (RT-PCR) method. We simultaneously analyzed human telomerase reverse transcriptase (hTERT), cytokeratin-19 (CK-19), cytokeratin-20 (CK-20) and carcinoembryonic antigen (CEA) mRNA (messenger RNA) expression in the peripheral blood of 42 gastric cancer patients and 30 healthy individuals. Additionally, analyses were carried out for the correlation of these four molecular markers with patients’ clinicopathologic features, as well as the occurrence of postoperative recurrence/metastasis. Among 42 gastric cancer patients, the prevalence of mRNA for hTERT, CK-19, CK-20, and CEA was 61.9% (26/42), 69% (29/42), 61.9% (26/42), and 78.6% (33/42), respectively. All 30 healthy individuals were negative for hTERT and CEA mRNA, while two were positive for either CK-19 mRNA or CK-20 mRNA. Positive CEA mRNA was significantly correlated with tumor size (p = 0.008), vessel invasion (p = 0.001), depth of tumor invasion (p = 0.007), lymph node metastasis (p < 0.001), and TNM stage (p < 0.001). In addition, the multivariate logistic regression demonstrated that CEA mRNA expression was an independent and significant predictor for postoperative recurrence/metastasis (p = 0.032). Our findings suggest that CEA mRNA may be a more reliable marker than hTERT, CK-19 and CK-20 for the detection of circulating cancer cells in gastric cancer patients' peripheral blood. Patients with positive CEA mRNA expression in peripheral blood have a significantly higher risk of postoperative recurrence/metastasis.