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Detection of tumor cell dissemination in pancreatic ductal carcinoma patients by CK 20 RT-PCR indicates poor survival

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Abstract

Purpose: This prospective study evaluates the diagnostic potential of Cytokeratin 20 (CK 20) RT-PCR for the detection of disseminated tumor cells in bone marrow and blood of a large cohort of patients with ductal adenocarcinoma of the pancreas and the prognostic value on overall survival prediction. Methods: Between 1994 and 2003, 172 patients (83 male, 89 female; 13–82 years) with pancreatic ductal adenocarcinoma underwent surgery. Bone marrow samples and venous blood were taken preoperatively and analyzed for disseminated tumor cells by nested CK 20 RT-PCR. Results: Disseminated tumor cells were detected in 81 (47.1%) of the 172 patients in the bone marrow and/or the venous blood. Overall, in 45 of the 135 (33.3%) bone marrow samples and in 52 of the 154 (33.8%) blood samples, CK 20 positive cells were detected. Detection rates increased with the UICC-tumor stage. According to Kaplan-Meier, univariate survival analysis of all 172 patients (n=78 R0-; n=18 R1- and n=5 R2-resected; n=71 palliative surgery) showed a statistically significant relationship of overall survival to radicality of the operation (P<0.0001), the UICC-stage of the tumors (P=0.0011) and the detection of disseminated tumor cells in bone marrow and/or venous blood (P=0.05). Patients with well- and moderately- differentiated tumors (G1 and G2) had a significantly longer survival (P=0.045) than patients suffering from poorly differentiated tumors (G3). A positive CK 20 status in the bone marrow and/or blood within the group of patients with G1 and G2 tumors had a significantly negative prognostic impact on their survival (P=0.046). Conclusions: Disseminated tumor cells can be detected in patients with pancreatic ductal adenocarcinoma by CK 20 RT-PCR. Detection rates are stage dependent, and survival analysis demonstrated statistically relevant data. From a clinical point of view, this finding is especially noteworthy for the group of well- and moderately-differentiated tumors.

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Authors and Affiliations

  1. Section Molecular Oncology, Department for General Surgery and Thoracic Surgery, University Clinic Schleswig-Holstein, Campus Kiel, Arnold-Heller Straße 7, 24105, Kiel, Germany

    Edlyn Soeth, Barbara Moellmann, Christian Röder, Bodo Schniewind, Bernd Kremer & Holger Kalthoff

  2. Department of Surgery, Städtisches Krankenhaus Kiel, Chemnitzstrasse 33, 24116, Kiel, Germany

    Urte Grigoleit & Ilka Vogel

Authors
  1. Edlyn Soeth
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  2. Urte Grigoleit
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  3. Barbara Moellmann
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  4. Christian Röder
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  5. Bodo Schniewind
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  6. Bernd Kremer
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  7. Holger Kalthoff
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  8. Ilka Vogel
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Correspondence to Ilka Vogel.

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Soeth, E., Grigoleit, U., Moellmann, B. et al. Detection of tumor cell dissemination in pancreatic ductal carcinoma patients by CK 20 RT-PCR indicates poor survival. J Cancer Res Clin Oncol 131, 669–676 (2005). https://doi.org/10.1007/s00432-005-0008-1

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  • DOI: https://doi.org/10.1007/s00432-005-0008-1

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