Monitoring of Circulating Tumor Cells in Patients Undergoing Surgery for Hepatic Metastases from Colorectal Cancer
Abstract
The aim of our study was to describe the frequency of occurrence of circulating tumor cells (CTCs) in patients undergoing surgery for liver metastases from colorectal cancer in relation to treatment (chemotherapy and surgery). We monitored the presence of CTCs before, during and after surgery.
PATIENTS AND METHODS: This prospective study involved 14 patients (9 men and 5 women) undergoing surgical resection or termoablation of liver metastases from colorectal carcinoma. Ten of them received chemotherapy before surgery.
Samples of central blood (7.5 ml) were drawn preoperatively, at the time of mobilization of the liver during the surgical procedure, immediately after surgery, and at two and seven days postoperatively. CTCs were detected by ColonCancerSelect and ColonCancerDetect kits (AdnaGen, Langenhagen, Germany).
RESULTS: CTCs were detected in three out of 14 patients. For each of the three patients, CTCs were detected via a different gene [tumor-associated antigen GA733-2, carcinoembryonic antigen (CEA) and epidermal growth factor receptor (EGFR)].
This demonstrates the heterogeneity of the CTC population among patients. In one patient, we recorded long-term presence of CTCs, in one patient we detected CTCs only during surgery and in one patient we detected CTCs only before surgery.
CTC-positive patients are described in the form of case reports. CONCLUSION: We detected CTCs only in a minority of patients with liver metastases from colorectal cancer.
Observations show that the surgical procedure itself can cause the presence of CTCs in the peripheral blood.