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Identification of occult tumor cells in node negative lymph nodes of colorectal cancer patients by cytokeratin 20 gene and protein expression

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Evaluation of cytokeratin 20 (CK20) specific quantitative reverse transcriptase polymerase chain reaction (QRT-PCR) and immunohistochemistry (IHC) for detection of occult tumor cells in lymph nodes of 72 patients with colorectal carcinoma (UICC stage I and II).

Methods

Serial sections of formalin-fixed, paraffin-embedded lymph nodes (mean 14.3/case) were used for microdissection, RNA isolation and QRT-PCR and for CK20 IHC using routine protocols. Results of QRT-PCR and IHC were compared and correlated to the CK20 expression pattern of the primary tumors and clinical follow-up.

Results

IHC revealed CK20-positive tumor cells in lymph nodes of 14.5% (10/69) and 0% (0/3) cases with a CK20-positive and CK20-negative primary tumor, respectively. CK20 mRNA was detected in the lymph nodes of 36.8% (7/19) cases by QRT-PCR with all 7 cases also expressing CK20 mRNA in the primary tumor. CK20 mRNA (QRT-PCR) and protein (IHC) detection in serial sections did not agree in 25% (5/20) of cases. A trend was seen towards a worse disease course for patients with CK20-positive lymph nodes by IHC (incidence of recurrent disease) and QRT-PCR (disease-free survival, incidence of recurrent disease).

Conclusion

CK20-specific IHC and QRT-PCR are supportive tools to conventional histology for detection of occult tumor cells in archival tissues, with the restriction that a laborious QRT-PCR procedure is necessary to achieve appropriate specificity. A prognostic value of CK20 IHC or QRT-PCR for stratification of UICC stage I and II patients into those likely to develop recurrent disease was not evident.

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Authors and Affiliations

  1. Pathologisches Institut, Universitätsklinikum Freiburg, Albertstrasse 19, 79104, Freiburg, Germany

    S. Lassmann & M. Werner

  2. Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    M. Bauer & H. Höfler

  3. Chirurgische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    R. Rosenberg & H. Nekarda

  4. Roche Diagnostics GmbH, Penzberg, Germany

    R. Soong & R. Rüger

Authors
  1. S. Lassmann
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  2. M. Bauer
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  3. R. Rosenberg
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  4. H. Nekarda
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  5. R. Soong
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  6. R. Rüger
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  7. H. Höfler
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  8. M. Werner
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Correspondence to S. Lassmann.

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Lassmann, S., Bauer, M., Rosenberg, R. et al. Identification of occult tumor cells in node negative lymph nodes of colorectal cancer patients by cytokeratin 20 gene and protein expression. Int J Colorectal Dis 19, 87–94 (2004). https://doi.org/10.1007/s00384-003-0530-z

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  • DOI: https://doi.org/10.1007/s00384-003-0530-z

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