Correlation Between Lymph Node Micrometastasis and Immune Function Status in Patients with Colorectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WEN Kunming ¹ , ZENG Qingliang ¹ , FENG Guoli ¹ , SONG Xuan ²

1.Department of Gastrointestinal Surgery, The Affiliated Hospital of Zunyi Medical College, Zunyi 563003, Giuzhou Province, China. 2.Department of Gastrointestinal Surgery, The people’s Hospital of Guizhou Province, Guiyang 550001, China.;

Corresponding author：

Keywords：

Colorectal cancer; Lymph node; Micrometastasis; Cytokeratin 20; Immune function

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To detect the expression of cytokeratin 20 (CK20) mRNA (micrometastasis) in regional lymph nodes and the serum activities of CD4+ cells, CD8+ cells and NK cells, serum levels of IL-2, IL-12 and sIL-2R in peripheral blood of patients with colorectal cancer; and to investigate the relationship between them. Methods Total 281 lymph nodes of 21 patients with colorectal cancer were collected. The positive expression of CK20 mRNA in lymph nodes was detect by reverse transcription-polymerase chain reaction (RT-PCR) and the metastasis in lymph nodes was detected by conventional pathological examination; the serum activities of CD4+ cells, CD8+ cells and NK cells were detected by flow cytometry and serum levels of IL-2, IL-12 and sIL-2R were detected by ELISA method in peripheral blood of patients with colorectal cancer. Results Among the positive metastasis in the 281 lymph nodes of the 21 patients, there were 16 (5.7%， 16/281) lymph nodes in 2 patients detected by pathological examination and 140 (49.8%， 140/281) lymph nodes in 10 patients by RT-PCR. There was a significant difference between the two measures in the aspects of the detection rate and the positive cases of lymph node metastasis in the 21 patients. Before operation, the serum activities of CD4+ cells, CD4+/CD8+ and NK cells, levels of IL-2 and IL-12 in 11 patients whose CK20 mRNA in regional lymph nodes were negative expression were higher than those in the other 8 patients whose lymph nodes metastasis were negative by conventional pathological examination but CK20 mRNA were positive expression （P＜0.05）; and the serum activity of CD8+ cells and level of sIL-2R in the former ones were lower than those in the latter ones （P＜0.05）. The serum activities of CD4+（r＝－0.769） cells, CD4+/CD8+（r=－0.755） and NK cells （r=－0.532）, the levels of IL-2 （r＝－0.834） and IL-12 （r＝－0.819） were negative correlated with the expression of CK20 mRNA （P＜0.05, P＜0.01）; and the activity of CD8+ cells （r=0.562） and level of sIL-2R （r=0.751） were positive correlated with the expression of CK20 mRNA （P＜0.05）. Conclusion The micrometastasis in lymph nodes is correlated significantly with the lower immune function of patients with colorectal cancer.

Citation： WEN Kunming,ZENG Qingliang,FENG Guoli,SONG Xuan. Correlation Between Lymph Node Micrometastasis and Immune Function Status in Patients with Colorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(11): 890-894. doi: Copy

1.	罗成华主编. 结直肠肿瘤 [M]. 北京：科学技术文献出版社, 2005：14-18.
2.	Noura S, Yamamoto H, Miyake Y, et al. Immunohistoche-mical assessment of localization and frequency of micrometastases in lymph nodes of colorectal cancer [Ｊ]. Clin Cancer Res, 2002; 8(3): 759-767.
3.	骆成玉, 李世拥, 赵丹宁, 等. 大肠癌淋巴结微转移的预后意义 [Ｊ]. 中华普通外科杂志, 2000; 15（3）: 133-135.
4.	苏琪, 韩霞, 殷红专. CK20诊断大肠癌微转移的价值 [Ｊ]. 世界华人消化杂志, 2004; 12（9）: 2153-2155.
5.	范跃祖, 李新平, 刘文方, 等. 大肠癌患者淋巴结微转移与肿瘤复发转移和预后 [Ｊ]. 中华普通外科杂志, 2005; 20（10）: 669-670.
6.	冯国丽，曾庆良，宋璇, 等. CD4+、CD8+和NK在结直肠癌中的表达及其与淋巴结微转移的关系 [Ｊ]. 中华实验外科杂志， 2009; 26(2): 159-161.
7.	Spiliotis J, Datsis A. The surgical approach to locally recurrent rectal cancer [Ｊ]. Tech Coloproctol, 2004; 8 Suppl 1: s33-s35.
8.	Yamaguchi K, Takagi Y, Aoki S, et al. Significant detection of circulating cancer cells in the blood by reverse transcriptase-polymerase chain reaction during colorectal cancer resection [Ｊ]. Ann Surg, 2000; 232(1): 58-65.
9.	Gunderson LL, Sargent DJ, Tepper JE, et al. Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis [Ｊ]. J Clin Oncol, 2004; 22(10): 1785-1796.
10.	Fujita S, Shimoda T, Yoshimura K, et al. Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection [Ｊ]. J Surg Oncol, 2003; 84(3): 127-131.
11.	Shinji S, Naito Z, Ishiwata T, et al. Clinical and biological significance of lymph node micrometastasis in colorectal cancer [Ｊ]. J Nippon Med Sch, 2007; 74(1): 77-80.
12.	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): 1350-1357.
13.	孙建伟，华映坤，贾玲, 等. 大肠癌患者外周血CK20mRNA的表达及其意义 [Ｊ]. 中国普外基础与临床杂志， 2004; 11（2）： 119-121.
14.	王忠诚, 王灿, 曾庆贵. 荧光定量聚合酶链反应检测大肠癌患者外周血癌细胞角蛋白20 mRNA [Ｊ]. 中华肿瘤杂志， 2007; 29(8): 600-603.
15.	Zhang XW, Yang HY, Fan P, et al. Detection of micrometastasis in peripheral blood by multi-sampling in patients with colorectal cancer [Ｊ]. World J Gastroenterol, 2005; 11(3): 436-438.
16.	Takano K, Kojima T, Ogasawara N, et al. Expression of tight junction proteins in epithelium including Ck20-positive M-like cells of human adenoids in vivo and in vitro [Ｊ]. J Mol Histol, 2008; 39(3): 265-273.
17.	Tanaka Y, Sano T, Qian ZR, et al. Expression of adhesion molecules and cytokeratin 20 in merkel cell carcinomas [Ｊ]. Endocr Pathol, 2004; 15(2): 117-129.
18.	McGregor DK, Wu TT, Rashid A, et al. Reduced expression of cytokeratin 20 in colorectal carcinomas with high levels of microsatellite instability [Ｊ]. Am J Surg Pathol, 2004; 28(6): 712-718.
19.	Kronberg U, López-Kostner F, Soto G, et al. Detection of lymphatic micrometastases in patients with stages Ⅰ and Ⅱ colorectal cancer: impact on five-year survival [Ｊ]. Dis Colon Rectum, 2004; 47(7): 1151-1157.
20.	李太原, 张海涛, 端木尽忠. 大肠癌门静脉微转移预后分析 [Ｊ]. 中国实用外科杂志， 2007; 27(8): 630-632.
21.	Salto-Tellez M, Kong SL, Leong AP, et al. Intrinsic variability in the detection of micrometastases in lymph nodes for re-staging of colorectal cancer. effect of individual markers and tissue samples [Ｊ]. Eur J Cancer, 2003; 39(9): 1234-1241.
22.	夏利刚，左敏，何文亮, 等. 直肠癌患者淋巴结美蓝染色及微转移的临床研究 [Ｊ]. 中华实验外科杂志， 2004; 21(9): 1139-1140.
23.	曾庆良，王正光，程家平, 等. 大肠癌患者血清IAP、sIL-2R和IL-12变化 [Ｊ]. 中国肿瘤, 2003; 12(7): 412-414.
24.	Wilkinson RW, Ross EL, Poulsom R, et al. Antibody targeting studies in a transgenic murine model of spontaneous colorectal tumors [Ｊ]. Proc Natl Acad Sci USA, 2001; 98(18): 10256-10260.
25.	龚丽明, 程若川, 李恩全. 大肠癌微转移检测的现状及展望 [Ｊ]. 大肠肛门病外科杂志, 2003; 9(2): 137-142.
26.	熊兵红, 程勇, 王严庆. 细胞角蛋白20检测在大肠癌微转移中的临床意义 [Ｊ]. 世界华人消化杂志, 2006; 14(14): 1394-1402.

1. 罗成华主编. 结直肠肿瘤 [M]. 北京：科学技术文献出版社, 2005：14-18.
2. Noura S, Yamamoto H, Miyake Y, et al. Immunohistoche-mical assessment of localization and frequency of micrometastases in lymph nodes of colorectal cancer [Ｊ]. Clin Cancer Res, 2002; 8(3): 759-767.
3. 骆成玉, 李世拥, 赵丹宁, 等. 大肠癌淋巴结微转移的预后意义 [Ｊ]. 中华普通外科杂志, 2000; 15（3）: 133-135.
4. 苏琪, 韩霞, 殷红专. CK20诊断大肠癌微转移的价值 [Ｊ]. 世界华人消化杂志, 2004; 12（9）: 2153-2155.
5. 范跃祖, 李新平, 刘文方, 等. 大肠癌患者淋巴结微转移与肿瘤复发转移和预后 [Ｊ]. 中华普通外科杂志, 2005; 20（10）: 669-670.
6. 冯国丽，曾庆良，宋璇, 等. CD4+、CD8+和NK在结直肠癌中的表达及其与淋巴结微转移的关系 [Ｊ]. 中华实验外科杂志， 2009; 26(2): 159-161.
7. Spiliotis J, Datsis A. The surgical approach to locally recurrent rectal cancer [Ｊ]. Tech Coloproctol, 2004; 8 Suppl 1: s33-s35.
8. Yamaguchi K, Takagi Y, Aoki S, et al. Significant detection of circulating cancer cells in the blood by reverse transcriptase-polymerase chain reaction during colorectal cancer resection [Ｊ]. Ann Surg, 2000; 232(1): 58-65.
9. Gunderson LL, Sargent DJ, Tepper JE, et al. Impact of T and N stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis [Ｊ]. J Clin Oncol, 2004; 22(10): 1785-1796.
10. Fujita S, Shimoda T, Yoshimura K, et al. Prospective evaluation of prognostic factors in patients with colorectal cancer undergoing curative resection [Ｊ]. J Surg Oncol, 2003; 84(3): 127-131.
11. Shinji S, Naito Z, Ishiwata T, et al. Clinical and biological significance of lymph node micrometastasis in colorectal cancer [Ｊ]. J Nippon Med Sch, 2007; 74(1): 77-80.
12. 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): 1350-1357.
13. 孙建伟，华映坤，贾玲, 等. 大肠癌患者外周血CK20mRNA的表达及其意义 [Ｊ]. 中国普外基础与临床杂志， 2004; 11（2）： 119-121.
14. 王忠诚, 王灿, 曾庆贵. 荧光定量聚合酶链反应检测大肠癌患者外周血癌细胞角蛋白20 mRNA [Ｊ]. 中华肿瘤杂志， 2007; 29(8): 600-603.
15. Zhang XW, Yang HY, Fan P, et al. Detection of micrometastasis in peripheral blood by multi-sampling in patients with colorectal cancer [Ｊ]. World J Gastroenterol, 2005; 11(3): 436-438.
16. Takano K, Kojima T, Ogasawara N, et al. Expression of tight junction proteins in epithelium including Ck20-positive M-like cells of human adenoids in vivo and in vitro [Ｊ]. J Mol Histol, 2008; 39(3): 265-273.
17. Tanaka Y, Sano T, Qian ZR, et al. Expression of adhesion molecules and cytokeratin 20 in merkel cell carcinomas [Ｊ]. Endocr Pathol, 2004; 15(2): 117-129.
18. McGregor DK, Wu TT, Rashid A, et al. Reduced expression of cytokeratin 20 in colorectal carcinomas with high levels of microsatellite instability [Ｊ]. Am J Surg Pathol, 2004; 28(6): 712-718.
19. Kronberg U, López-Kostner F, Soto G, et al. Detection of lymphatic micrometastases in patients with stages Ⅰ and Ⅱ colorectal cancer: impact on five-year survival [Ｊ]. Dis Colon Rectum, 2004; 47(7): 1151-1157.
20. 李太原, 张海涛, 端木尽忠. 大肠癌门静脉微转移预后分析 [Ｊ]. 中国实用外科杂志， 2007; 27(8): 630-632.
21. Salto-Tellez M, Kong SL, Leong AP, et al. Intrinsic variability in the detection of micrometastases in lymph nodes for re-staging of colorectal cancer. effect of individual markers and tissue samples [Ｊ]. Eur J Cancer, 2003; 39(9): 1234-1241.
22. 夏利刚，左敏，何文亮, 等. 直肠癌患者淋巴结美蓝染色及微转移的临床研究 [Ｊ]. 中华实验外科杂志， 2004; 21(9): 1139-1140.
23. 曾庆良，王正光，程家平, 等. 大肠癌患者血清IAP、sIL-2R和IL-12变化 [Ｊ]. 中国肿瘤, 2003; 12(7): 412-414.
24. Wilkinson RW, Ross EL, Poulsom R, et al. Antibody targeting studies in a transgenic murine model of spontaneous colorectal tumors [Ｊ]. Proc Natl Acad Sci USA, 2001; 98(18): 10256-10260.
25. 龚丽明, 程若川, 李恩全. 大肠癌微转移检测的现状及展望 [Ｊ]. 大肠肛门病外科杂志, 2003; 9(2): 137-142.
26. 熊兵红, 程勇, 王严庆. 细胞角蛋白20检测在大肠癌微转移中的临床意义 [Ｊ]. 世界华人消化杂志, 2006; 14(14): 1394-1402.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Correlation Between Lymph Node Micrometastasis and Immune Function Status in Patients with Colorectal Cancer

Abstract Full text Figures/Tables Video References Cited by

Format

Content