Multipoint quantification of multimarker genes in peripheral blood and micrometastasis characteristic in peri-operative esophageal cancer patients

This work proposed a method to assess the occult micrometastasis characteristic in peri-operative peripheral blood (PB) based on multipoint quantification of multimarker genes by real-time semiquantitative RT-PCR. The expression levels of SCC, CK19, CK20, CEA and survivin mRNA in PB samples collected before surgery (B − 1), immediately after surgery (B0) and at the third day post-operatively (B + 3) from 36 squamous esophageal cancer (EC) patients were detected. SCC and CK19 mRNA showed low positivity detection rates, while the rate for CEA and survivin mRNA panel was 58.3%, 83.3% and 72.3% at B − 1, B0 and B + 3, respectively. Opposite to the significant increase and slow decrease of CEA cells at stages of B − 1 to B0 and B0 to B + 3, respectively, survivin cells decreased significantly and increased quickly at the two stages. The follow-up with a period of 1.2 years showed that the patients with the B + 3/B0 ratios of ⩾0.3 for CEA cells or/and ⩾10 for survivin cells exhibited significantly high possibility of developed metastasis, and the sensitivity to predict developed metastasis increased from 54.5% of CEA mRNA alone to 72.7% of CEA and survivin mRNA panel. These results suggested that CEA and survivin gene panel improved the sensitivity to predict recurrence and differentiate the micrometastatic process.