THE PRESENCE OF CIRCULATING TUMOR CELLS IS A NEGATIVE PROGNOSTIC FACTOR IN PANCREATIC CANCER

Konference: 2012 3. pražské mezioborové onkologické kolokvium Prague ONCO

Kategorie: Gastrointestinální nádory

Téma: Postery

Číslo abstraktu: 052

Autoři: Mgr. Andrea Benedíková; MUDr. Josef Srovnal, Ph.D.; MUDr. JUDr. Dušan Klos, Ph.D., LL.M.; MUDr. Martin Loveček, Ph.D.; doc. MUDr. Roman Havlík, Ph.D.; Bc. Dana Cahová; MUDr. Karel Cwiertka, Ph.D.; doc. MUDr. Marián Hajdúch, Ph.D.

Introduction

We tested the hypothesis that the presence of circulating tumour cells (CTCs) is a negative prognostic factor in patients with pancreatic cancer. Pancreatic cancer is one of the most aggressive malignancies with the poor prognosis. Assessment of the CTCs in patients with this highly malignant disease could prevent burdensome surgery in patients with systemic dissemination.

Patients and methods

This was a prospective study to test for the presence of CTCs in peripheral blood, portal blood (tumour draining blood), bone marrow and peritoneal lavage in 136 pancreatic cancer patients at the time of surgery using real-time RT-PCR for carcinoembryonic antigen (CEA), epidermal growth factor receptor 1 (EGFR) and human telomerase (hTERT). Absolute gene expressions of tested markers were correlated with clinical/pathological characteristics and survival parameters.

Results

Overall, 92 of 136 (67.6 %) pancreatic cancer patients died, the overall survival median was 10.3 months. We found a statistically significant association between EGFR and hTERT expression levels in the portal blood and CEA and EGFR expression levels in peritoneal lavage and clinical stage. We also showed, that patients with presence of CTCs detected in either peripheral blood, portal blood or peritoneal lavage using combination of CEA and/ or EGFR and/or hTERT had significantly shorter overall survival (p <0.07; resp. p <0.005; resp. p<0.01) and higher hazard ratio (HR 1.42; resp. HR 1.95; resp. 1.62) compared to patients with CTCs negativity in those compartments.

Conclusion

The results of this study demonstrate a high sensitivity and specificity of the real-time RT-PCR method for CTC detection in pancreatic cancer. Detection of CTCs seems to be a negative prognostic factor for overall survival in pancreatic cancer patients and can influence the radical surgery decision.

Acknowledgments of research support This study was supported by grants MSMT CR 6198959216, IGA MZ CR NS 9937-4 and LC07017. Infrastructural part of this project (Institute of Molecular and Translational Medicine) was supported from the Operational Programme Research and Development for Innovations (project CZ.1.05/2.1.00/01.0030).

e-mail: benedikova.andrea@seznam.cz

Datum přednesení příspěvku: 26. 1. 2012