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Hematogenous tumor cell dissemination during colonoscopy for colorectal cancer

  • M. Koch
  • P. Kienle
  • P. Sauer
  • F. Willeke
  • K. Buhl
  • A. Benner
  • T. Lehnert
  • C. Herfarth
  • M. von Knebel Doeberitz
  • J. WeitzEmail author
Original article

Abstract

Background: It has long been suspected that mechanical influences may enhance the release of viable colorectal cancer cells into the circulation. The objective of this study was to determine the extent of hematogenous tumor cell spread in colorectal cancer patients during colonoscopy. Methods: Peripheral venous blood samples were taken before and after colonoscopy from 44 patients with colorectal cancer. Blood samples were examined using a reverse-transcriptase polymerase chain reaction assay to amplify cytokeratin 20 transcripts. Results: Eleven patients with colorectal cancer displayed circulating tumor cells before and after colonoscopy (25%), whereas tumor cells were detected in six of 44 patients (14%) only after the procedure (p = 0.03, McNemar’s test: tumor cell detection before after colonoscopy). All control samples consistently tested negative. Conclusions: Mechanical forces may result in enhanced release of viable colorectal cancer cells into the circulation; however, the clinical significance of these results needs to be clarified.

Keywords

Colorectal cancer Colonoscopy Reverse-trascriptase-polymerase chain reaction Tumor cell dissemination 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • M. Koch
    • 1
    • 2
  • P. Kienle
    • 1
    • 2
  • P. Sauer
    • 3
  • F. Willeke
    • 1
    • 2
  • K. Buhl
    • 2
  • A. Benner
    • 4
  • T. Lehnert
    • 2
  • C. Herfarth
    • 1
    • 2
  • M. von Knebel Doeberitz
    • 2
  • J. Weitz
    • 1
    • 2
    Email author
  1. 1.Division for Molecular Diagnostics and Therapy, Department of SurgeryUniversity of Heidelberg, INF 110, D-69120 HeidelbergGermany
  2. 2.Division for Surgical Oncology of the Department of SurgeryUniversity of Heidelberg, INF 110, D-69120 HeidelbergGermany
  3. 3.Department of MedicineUniversity of Heidelberg, INF 110, D-69120 HeidelbergGermany
  4. 4.Central Unit BiostatisticsGerman Cancer Research Center, D-69120 HeidelbergGermany

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