Perioperative quantitative analysis of cytokeratin 20 mRNA in peripheral venous blood of patients with colorectal adenocarcinoma

Hematogenous dissemination is a significant shortcoming of colorectal carci noma treatment. To screen patients with high risk for such blood-borne meta stasis, we previously developed a highly sensitive system for the detection of cytokeratin 20 (CK-20) mRNA in blood. For a more practical application, we improved this system by making it quantitative and capable of analyzing peripheral venous blood for the detection of perioperative changes in CK-2 0 mRNA. CK-20 mRNA was not always detected in the preoperative blood, even in patients in an advanced stage, but it was identified without fail in int ra- and post-operative blood. In addition, more copies of CK-20 mRNA were o bserved in the intraoperative blood than in pre- and post-operative blood. This study suggests that analysis of perioperative changes may provide impo rtant information for the precise evaluation of hematogenous dissemination and of the effect of surgical maneuvers on recurrence.