Detection of residual micro-cancer cells by the assessment of telomerase activities in postoperative pleural effusion after esophagectomy for esophageal cancer

1998 Fiscal Year Final Research Report Summary

• Project/Area Number: 08671421
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: NIIGATA UNIVERSITY
• Principal Investigator: NISHIMAKI Tadasi Niigata University Medical Hospital, Lecturer, 医学部附属病院, 講師 (70242427)
• Co-Investigator(Kenkyū-buntansha): SUZUKI Tsutomu Niigata University School of Medicine, Associate Professor, 医学部, 助教授 (40183420)
• Project Period (FY): 1997 – 1998
• Keywords: esophageal cancer / residual micro-cancer cells / local recurrence / telomerase activity / cytology

Research Abstract

To determine whether cytologic examination and telomerase activity assessment are useful to detect residual micro-cancer cells in the resection sites, we performed these tests in the postoperative pleural effusion from patients with esophageal cancer undergoing esophagectomy. Positive cytology (Papanicolaou class IV and V) was detected in the postoperative pleural effusions from 23(40%) of 57 patients with esophageal cancer after esophageal resection. There no difference in depth of primary tumor invasion and frequencies of positive vessel invasion and lymph node metastasis between the 23 patients with positive cytology and 34 patients with negative cytology. Recurrent disease occurred in 11 (48%) of the former patients and 14 (41%)of the latter patients. Local tumor recurrence was found in 64% of the 11 patients with positive cytology and in 36% of the 14 patients with negative cytology. However, there was no significant difference in local recurrence rates between the two patient gro ups. The 4-year survival rates of the 23 patients with positive cytology were 60%. Likewise, those survival rates were 60% in the 34 patients with negative cytology. We also examined correlation between cytologic results and telomerase activities assessed by the TRAP method in the postoperative pleural effusions from other 14 patients with esophageal cancer undergoing esophagectomy. All of the 14 patients were revealed to have negative cytology and no detectable telomerase activities in the pleural effusion. These findings suggest that cancer cells can be scattered in the resection sites after esophagectomy in some patients with esophageal cancer, that residual micro-cancer cells are not reliable indicators of increased risk of local tumor recurrence after esophagectomy for esophageal cancer, and that telomerase activities may correlate with cytologic examination to detect residual micro-cancer cells in the postoperative pleural effusions after esophagectomy in patients with the disease.