2004 Fiscal Year Final Research Report Summary
Molecular detection of occult cancer cells in sentinel lymph node of gastrointestinal and breast cancer
| Project/Area Number |
15591451
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Aichi Medical University |
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Principal Investigator |
JOTSUKA Toko Aichi Medical University, Surgery, Research Associate, 医学部, 助手 (80351104)
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| Co-Investigator(Kenkyū-buntansha) |
YAMASHITA Jun-ichi Aichi Medical University, Surgery, Professor, 医学部, 教授 (20279285)
NAKANO Shogo Aichi Medical University, Surgery, Assistant Professor, 医学部, 講師 (20351108)
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| Project Period (FY) |
2003 – 2004
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| Keywords | gastrointestinal cancer / breast cancer / molecular detection / micrometastasis / prognosis / sentinel lymph node |
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| Research Abstract |
The decision to offer systemic adjuvant therapy to a patient with breast cancer depends on the balance between expected benefit (improved relapse-free and overall survival) and expected risk (adverse effects). Involvement of axillary lymph nodes strongly predicts early relapse, and is widely considered an indication for adjuvant therapy. Node-negative patients generally have a more favorable prognosis, and often receive no further treatment after the primary operation. However, in Japan, distant metastases develop in approximately 10% to 15% of these patients, who ultimately die of their disease. Many clinical randomized trials have generated new evidence of efficacy of adjuvant therapy for primary breast cancer. Recent developments in molecular technology including the polymerase chain reaction (PCR) now permit sensitive detection of circulating tumor cells in peripheral blood. Several researchers have used carcinoembryonic antigen (CEA) as the target gene because CEA mRNA can be detected in almost all epithelial cells including cancer cells, but not in nonepithelial cells. CEA mRNA detected in blood samples implies the presence of blood-borne epithelial cells, presumably cancer cells. Considering this background, we prospectively studied 100 consecutive patients undergoing curative surgery for node-negative breast cancer to test whether tumor cell detection in peripheral blood by CEA mRNA RT-PCR was a prognostic indicator. Patients with CEA mRNA in preoperative samples had poorer survival than those with no detectable CEA mRNA. The worst survival rate was seen in those with CEA mRNA in both pre-and postoperative samples. Molecular detection of CEA mRNA in both pre-and postoperative blood samples is an independent negative prognostic factor in patients with node-negative breast cancer undergoing curative surgery.
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