Detection of cytokeratin 19 and 20 mRNA in peripheral and mesenteric bloodfrom colorectal cancer patients and their prognosis

To detect the presence of cancer cells in peripheral and mesenteric blood a nd to examine their relationship to prognosis in colorectal cancer patients undergoing curative surgery, we examined cytokeratin 19 and 20 mRNA in per ipheral and mesenteric venous blood. Using reverse transcriptase polymerase chain reaction, cytokeratin 19 and 20 mRNA was amplified in peripheral and mesenteric blood samples obtained from 35 colorectal cancer patients who u nderwent curative surgery. Cytokeratin 19 or 20 mRNA in peripheral or mesen teric blood samples was detected in 18 of 35 cases (51%). There was no sign ificant difference in Dukes' staging between the positive and negative grou ps. The median follow-up period was 56 months. In the positive group six pa tients (33%) showed recurrences. One patient (6%) showed recurrence in the negative group. The recurrence rate was significantly higher in the positiv e group than in the negative group. Five-year disease-free survival was sig nificantly better in the negative group than in the positive group (94% vs. 65%). The detection of cytokeratin 19 or 20 mRNA in peripheral or mesenter ic blood is thus associated with the prognosis for colorectal cancer patien ts undergoing curative surgery. Although the presence of these mRNAs in blo od samples is a prognostic marker, the clinical utility of this assay is qu estionable because of the low recurrence rate in the positive group.