World Journal of Surgery

, Volume 39, Issue 9, pp 2329–2335 | Cite as

Preoperative Prediction of Lymph Node Status by Circulating Mir-18b and Mir-20a During Chemoradiotherapy in Patients with Rectal Cancer

  • Azadeh Azizian
  • Frank Kramer
  • Peter Jo
  • Hendrik A. Wolff
  • Tim Beißbarth
  • Robert Skarupke
  • Markus Bernhardt
  • Marian Grade
  • B. Michael Ghadimi
  • Jochen GaedckeEmail author
Original Scientific Report



In locally advanced rectal cancer, therapeutic success of preoperative chemoradiotherapy (CRT) ranges from resistance to complete regression. For those patients that respond well to CRT, local resection (LR) procedures are currently under investigation to minimize surgical morbidity and to improve functional outcome. To maintain the oncologic benefit appropriate staging procedures are essential. However, current clinical assessment and imaging techniques need further improvement.


Five miRNAs associated with rectal cancer (miR-17, miR-18b, miR-20a, miR-31, and miR-193-3p) were analyzed in the plasma of rectal cancer patients (n = 42) using qPCR. Expression levels were assessed before, during and after CRT and analyzed in regard to patients’ lymph node status obtained after total mesorectal excision and intensive histopathological work-up.


Four of the five miRNAs revealed reliable results in the plasma. miR-31 was excluded due to its low expression. MicroRNA-17, 18b, 20a, and 193-3p showed altering expression levels at different time points. Only 43 % (miR-17), 43 % (miR-18b), 53 % (miR-20a), and 60 % (miR-193-3p) showed a continuous in- or decrease of miRNA expression. The reduced expression of miR-18b and miR-20a during CRT was found to be significantly associated with postoperative lymph node negativity (p < 0.05).


MicroRNA expression in patient plasma changes during preoperative CRT. The alteration is not continuous and the meaning requires additional analysis on a larger patient cohort. The co-occurrence of reduced miR-18b and miR-20a expression with lymph node negativity after preoperative CRT could help to stratify the surgical procedure with respect to total mesorectal excision and LR if validated prospectively.


Rectal Cancer Negative Predictive Value miRNA Expression Total Mesorectal Excision Magnetic Resonance Imaging Data 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



For technical support acquisition, we thank Chan Rong Lai. The work is part of the Clinical Research Unit (KFO 179) and was supported by the Deutsche Forschungsgemeinschaft.

Conflict of interest statement

The authors declare no conflict of interest.

Supplementary material

268_2015_3083_MOESM1_ESM.docx (302 kb)
Supplementary material 1 (DOCX 301 kb)


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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Azadeh Azizian
    • 1
    • 4
  • Frank Kramer
    • 2
  • Peter Jo
    • 1
  • Hendrik A. Wolff
    • 3
  • Tim Beißbarth
    • 2
  • Robert Skarupke
    • 1
  • Markus Bernhardt
    • 1
  • Marian Grade
    • 1
  • B. Michael Ghadimi
    • 1
  • Jochen Gaedcke
    • 1
    Email author
  1. 1.Department of General, Visceral and Pediatric SurgeryUniversity Medical Center GöttingenGöttingenGermany
  2. 2.Departments of Medical StatisticsUniversity Medical Center GöttingenGöttingenGermany
  3. 3.Departments of RadiotherapyUniversity Medical Center GöttingenGöttingenGermany
  4. 4.Department of General and Visceral SurgeryUniversity Medical Center GöttingenGöttingenGermany

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