Perioperative cancer cell dissemination detected with a real-time RT-PCR assay for EpCAM is not associated with worse prognosis in pancreatic ductal adenocarcinomaReport as inadecuate

Perioperative cancer cell dissemination detected with a real-time RT-PCR assay for EpCAM is not associated with worse prognosis in pancreatic ductal adenocarcinoma - Download this document for free, or read online. Document in PDF available to download.

BMC Cancer

, 11:47

Clinical oncology


BackgroundEpithelial cell adhesion molecule EpCAM has been used as surrogate marker for the quantification of circulating tumour cells CTC. Our aim was to prospectively study the value of a real-time RT-PCR assay for EpCAM detection in the peripheral blood and peritoneal cavity of patients undergoing pancreatectomy for pancreatic ductal adenocarcinoma PDAC.

MethodsFrom 48 patients with PDAC 40 resectable, 8 unresectable and 10 patients with chronic pancreatitis undergoing pancreatectomy 10 ml of venous blood was drawn preoperatively PB and postoperatively POB, day 1 D1B, day 7 D7B and after 6 weeks 6WB. Of all patients undergoing pancreatectomy, 40 ml peritoneal lavage fluid was taken preoperatively and postoperatively. A real-time RT-PCR assay TaqMan, ABI Prism 7700 was developed for the detection of EpCAM mRNA. To discriminate between EpCAM-positive and negative samples a cut-off was applied. Median postoperative follow-up was 24.0 months range: 0.7 - 41.3.

ResultsPB was EpCAM-positive + in 25% of patients versus 65% of patients in POB p < 0.0001. EpCAM+ was noted at D1B, D7B and 6WB was found in 28.6%, 23.1% and 23.5% of patients respectively. Preoperative peritoneal lavage fluid was EpCAM+ in 10.3% versus 53.8% of patients postoperatively p < 0.0001.

At none of the time-points, an association was found between EpCAM positivity in blood and-or peritoneal cavity and cancer-specific or disease-free survival. Also, no significant associations were found between clinicopathological variables and perioperative EpCAM positivity.

ConclusionsDespite a significant increase in EpCAM counts in postoperative blood and peritoneal lavage fluid this was not associated with worse prognosis after pancreatectomy for PDAC.

Trial NCT00495924

List of abbreviationsCTCcirculating tumour cells

PDACpancreatic ductal adenocarcinoma

RT-PCRreverse transcriptase-polymerase chain reaction

EpCAMEpithelial Cell Adhesion Molecule



PRpancreatic resection

Ttumour samples

Pnon-tumoural control samples

NCNnormalized copy numbers

PBpreoperative blood

PoBpostoperative blood, immediately after surgical resection

D1Bpostoperative day 1

D7Bpostoperative day 7, 6W at 6 weeks, CSS: cancer-specific survival

DFSdisease-free survival

pGtumour differentiation

pNlymph node metastasis

pTtumour depth

Rresection margin positivity

PNIperineural invasion

LVILymphovascular invasion

ECLNIextracapsular lymph node involvement

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-11-47 contains supplementary material, which is available to authorized users.

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Author: Gregory Sergeant - Tania Roskams - Jos van Pelt - François Houtmeyers - Raymond Aerts - Baki Topal


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