BACKGROUND Several prognostic factors were proposed to improve early detection of recurrence after liver resection of metastases of colorectal cancer. Circulating tumor cell-related transcripts were evaluated in colorectal cancer patients with conflicting results. The aim of this study was to investigate usefulness of carcinoembryonic antigen CAM5, epidermal growth factor receptor, and ERCC1 transcripts in the bloodstream as predictive factors of recurrence in patients who underwent liver resection for metastases of colorectal cancer. METHODS Peripheral blood was collected from 29 patients at the time of the colorectal cancer liver metastasis resection, and from 25 normal controls. Follow-up draws (FUDs) were also performed at 30 days, and 3 and 12 months since surgery. On each sample, carcinoembryonic antigen CAM5, ERCC1, and GAPDH mRNAs were examined by quantitative reverse transcription (qRT). RESULTS Carcinoembryonic antigen transcript levels were linearly correlated to the number of spiked cells (qRT analytical limit = five cells). Among 29 patients (20 M/9 F; mean age 63 years (range 32-79), highly significant levels of carcinoembryonic antigen, if compared to the baseline, were detected in those relapsing after surgery (P <0.05). The main differences were between the 1st- and 12th-month FUDs. Significantly higher levels of carcinoembryonic antigen were also detected in patients who died from disease progression during the follow-up (as evaluated at 30 days and 90 days FUDs). CONCLUSIONS Blood carcinoembryonic antigen-mRNA absolute copy number overtime variation can represent a valid early predictor of relapse after liver resection in colorectal liver metastases patients. Prospective studies, in the context of large clinical trials, will provide further data to also qualify ERCC1 as a predictive biomarker for decisions on therapeutic strategies.

中文翻译：

---

血液中循环肿瘤细胞相关转录物作为结直肠转移肝切除术后早期复发的预后生物标志物。

背景 提出了几个预后因素来改善结直肠癌转移肝切除术后复发的早期检测。在结直肠癌患者中评估了循环肿瘤细胞相关的转录物，结果相互矛盾。本研究的目的是探讨血液中癌胚抗原 CAM5、表皮生长因子受体和 ERCC1 转录物作为结直肠癌转移肝切除患者复发的预测因素的有用性。方法采集29例结直肠癌肝转移切除患者和25例正常对照者的外周血。术后第 30 天、第 3 个月和第 12 个月也进行了随访抽签 (FUD)。在每个样品上，癌胚抗原 CAM5、ERCC1、通过定量逆转录（qRT）检查和 GAPDH mRNA。结果 癌胚抗原转录物水平与加标细胞数呈线性相关（qRT 分析限 = 5 个细胞）。在 29 名患者（20 M/9 F；平均年龄 63 岁（范围 32-79）中，与基线相比，在术后复发的患者中检测到高度显着的癌胚抗原水平（P <0.05）。主要差异在第 1 个月和第 12 个月 FUD 之间。在随访期间死于疾病进展的患者中也检测到显着更高水平的癌胚抗原（在 30 天和 90 天 FUD 时评估）。结论 血液癌胚抗原-mRNA 绝对拷贝数随时间变化可以代表结直肠肝转移患者肝切除术后复发的有效早期预测指标。在大型临床试验的背景下，前瞻性研究将提供进一步的数据，以使 ERCC1 也成为治疗策略决策的预测性生物标志物。