Detection of Spreading Scope of Rectal Cancer to Mesorectum with RT-PCR and Its Clinical Significance_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xiaolin ¹ , QING Sanhua ² , HUANG Xiangcheng ² , SONG Jingxiang ² , WU Chengtang. ²

Department of General Surgery,The 323rd Hospital of PLA, Xi’an 710054,China;

Corresponding author：

Keywords：

RT-PCR Carcinoembryonic antigen Rectal cancer Mesorectum

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【Abstract】ObjectiveTo detect the spreading scope of rectal cancer to mesorectum by RT-PCR using carcinoembryonic antigen (CEA) mRNA as a marker and to investigate the excision scope of mesorectum in resection of rectal cancer.
MethodsForty specimens from 40 rectal cancer patients who underwent curative operation was employed to detect the metastatic deposits scattered in the mesorectum by RT-PCR using CEA as a marker.
ResultsNine of 40 (22.5%) specimens contained metastatic deposits scattered in the mesorectum. The metastasis was just within the range of 4cm mesorectum under the verge of tumor. The tumor spreading to mesorectum is correlated with Dukes stages，the infiltrated depth of bowel wall, tumor differentiation and tumor type(P＜0.05), and is not correlated with the size of tumor and the level of CEA(P gt;0.05).
ConclusionThe excision of mesorectum should be within the range of 5cm under the verge of tumor in surgical management of rectal cancer.

Citation： WANG Xiaolin,QING Sanhua,HUANG Xiangcheng,SONG Jingxiang,WU Chengtang.. Detection of Spreading Scope of Rectal Cancer to Mesorectum with RT-PCR and Its Clinical Significance. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(1): 29-32. doi: Copy

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1. Reynolds JV, Joyce WP, Dolan J, et al. Pathological evidence in support of total mesorectal excision in the management of rectal cancer [Ｊ]. Br J Surg, 1996; 83(8)∶1112.
2. Scott N, Jackson P, alJaberi T, et al. Total mesorectal excision and local recurrence: a study of tumour spread in the mesorectum distal to rectal cancer [Ｊ]. Br J Surg， 1995; 82(8)∶1031.
3. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgerythe clue to pelvic recurrence? [Ｊ]. Br J Surg，1982; 69(10)∶613.
4. McCall JL, Cox MR, Wattchow DA. Analysis of local recurrence rates after surgery alone for rectal cancer [Ｊ]. Int J Colorectal Dis， 1995; 10(3)∶126.
5. Leather AJ, Gallegos NC, Kocjan G, et al. Detection and enumeration of circulating tumour cells in colorectal cancer [Ｊ]. Br J Surg， 1993; 80(6)∶777.
6. 谷志远. 现代医学分子生物学 [M]. 北京：人民军医出版社， 1998∶430～433.
7. Miyake Y, Yamamoto H, Fujiwara Y, et al. Extensive micrometastases to lymph nodes as a marker for rapid recurrence of colorectal cancer: a study of lymphatic mapping [Ｊ]. Clin Cancer Res， 2001; 7(5)∶1350.
8. Bilchik AJ, Saha S, Wiese D, et al. Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial [Ｊ]. J Clin Oncol， 2001; 19(4)∶1128.
9. Futamura M, Takagi Y, Koumura H, et al. Spread of colorectal cancer micrometastases in regional lymph nodes by reverse transcriptasepolymerase chain reactions for carcinoembryonic antigen and cytokeratin 20 [Ｊ]. J Surg Oncol， 1998; 68(1)∶34.
10. Datta YH, Adams PT, Drobyski WR, et al. Sensitive detection of occult breast cancer by the reversetranscriptase polymerase chain reaction [Ｊ]. J Clin Oncol， 1994; 12(3)∶475.
11. Adam IJ, Mohamdee MO, Martin IG, et al. Role of circumferential margin involvement in the local recurrence of rectal cancer [Ｊ]. Lancet， 1994; 344(8924)∶707.
12. Quirke P, Durdey P, Dixon MF, et al. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision [Ｊ]. Lancet，1986; 2(8514)∶996.
13. Tocchi A, Mazzoni G, Lepre L, et al. Total mesorectal excision and low rectal anastomosis for the treatment of rectal cancer and prevention of pelvic recurrences [Ｊ]. Arch Surg， 2001; 136(2)∶216.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Detection of Spreading Scope of Rectal Cancer to Mesorectum with RT-PCR and Its Clinical Significance

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