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The expression of carcinoembryonic antigen mRNA in the lavage of the dissected area of the lateral lymph nodes influences the lateral recurrence of lower rectal cancer

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Abstract

Purpose

To determine whether or not migrating cancer cells are present on the surgical plane after lateral lymph node dissection (LLND) for lower rectal cancer and related to lateral recurrence (LR), we evaluated the lavage of LLND areas by reverse-transcription polymerase chain reaction (RT-PCR) to check the expression of CEA mRNA in the residual cancer cells.

Methods

Thirty patients who underwent curative LLND were enrolled. Lavage was collected after LLND and subjected to RT-PCR to detect CEA mRNA. The median follow-up to check for recurrence was 31.4 months.

Results

CEA mRNA was detected in 9 of the 46 dissected areas. Based on the receiver operating characteristic curves, the cut-off value of PCR was set at 0.025. This cut-off point classified five patients into the high-expression group for CEA mRNA. During follow-up, LR developed in 1 of 40 low-expression areas of CEA mRNA and 3 of 6 high-expression areas. The LR rate was higher in the high-expression group than in the low-expression group (p = 0.015). A multivariate analysis showed that the high expression of CEA mRNA was likely an independent prognostic factor of LR.

Conclusion

The expression of CEA mRNA in the lavage of LLND areas indicates the presence of residual cancer cells that cause LR.

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Acknowledgements

We thank Professor Satoshi Osaga, who belongs to Department of Clinical Research Management Center, Nagoya City University Graduate School of Medical Sciences, for his helpful discussion and comments on the manuscript. In the Cox regression analysis, he advised us to use the Firth method for correction.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Nagoya Mizuho-ku, Nagoya, 467-8602, Japan

    Korehito Takasu, Masayasu Hara, Takeshi Yanagita, Nozomu Nakai, Nanako Ando, Yuzo Maeda, Takahisa Hirokawa, Kazuyoshi Shiga, Yoichi Matsuo, Hiroki Takahashi & Shuji Takiguchi

  2. Department of Gastroenterological Surgery, Nagoya City University West Medical Center, Nagoya, Japan

    Masayasu Hara

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  1. Korehito Takasu
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Correspondence to Masayasu Hara.

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Takasu, K., Hara, M., Yanagita, T. et al. The expression of carcinoembryonic antigen mRNA in the lavage of the dissected area of the lateral lymph nodes influences the lateral recurrence of lower rectal cancer. Surg Today 52, 84–91 (2022). https://doi.org/10.1007/s00595-021-02347-w

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  • DOI: https://doi.org/10.1007/s00595-021-02347-w

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