T. Nakamura et al., Immunocytochemical detection of circulating esophageal carcinoma cells by immunomagnetic separation, ANTICANC R, 20(6C), 2000, pp. 4739-4744
Background: Recent developments in detection of micrometastasis have reveal
ed a considerable incidence of systemic disease in patients who would previ
ously have been diagnosed as having solid rumours only. The purpose of this
study was to investigate the prevalence and clinical significance of circu
lating carcinoma cells in patients with esophageal squamous cell carcinoma
(ESCC). Materials and Methods: Peripheral blood samples from 47 primary ESC
C patients were enriched by immunomagnetic separation (IMS) using Ber-EP4-c
onjugated beads (Dynabeads anti-epithelial cell) and immunostained with an
anti-cytokeratin (anti-CK) antibody. We assayed samples from 12 patients to
compare the detection of CK-reactive cells using IMS with the detection of
CK 19 mRNA using a reverse transcriptase-polymerase chain reaction (RT-PCR
) method Results: CK-reactive cells were observed in 18 out of 47 patients
(38%). The detection rate was closely correlated with the stage of disease
(TNM stage) (p = 0.0017). In 33 patients who underwent esophagectomy, 4 out
of 7 patients (57%) positive for CK cells and only 2 out of 26 patients (7
.7%) negative suffered from recurrence in the distant lymph nodes or lungs
(p = 0.0108). When IMS and RT-PCR were compared, am 3 samples that were CK-
positive by IMS had CK 19 mRNA detected by RT-PCR. However, the other 4 sam
ples with CK 19 mRNA by RT-PCR were negative for CK cells by IMS. Of 7 pati
ents positive for CK-reactive cells before chemotherapy or chemoradiotherap
y, 4 patients negative after treatment survived bur 3 patients who remained
positive died within 6 months. Conclusion: Immunocytochemical detection of
circulating carcinoma cells by IMS may be a specific method for the diagno
sis of systemic disease and for monitoring treatment response.