Elsevier

The Lancet

Volume 345, Issue 8960, 20 May 1995, Pages 1257-1259
The Lancet

Genetic diagnosis of lymph-node metastasis in colorectal cancer

https://doi.org/10.1016/S0140-6736(95)90922-2Get rights and content

Abstract

If a regional lymph node taken during surgery for colorectal cancer is found to be free of tumour on histological examination this is taken to be a good sign. However, conventional staining may not be sensitive enough. Mutant-allele-specific amplification (MASA) is a technique that can detect, at the level of an individual cell, micrometastases to lymph nodes that are histologically diagnosed as negative. To examine the prognostic significance of such genetically detectable tumour cells we screened 120 colorectal cancers from patients who had no histologically detectable lymph-node metastasis at the time of surgery for mutations in K-ras (codons 12, 13, and 61) or p53 (exons 5-8). Somatic mutations were identified by MASA in 71 tumours. We next examined preserved tissues from corresponding regional lymph nodes, using MASA to look for the specific mutation found in the primary. Of 37 patients with genetically positive lymph nodes 27 had had a tumour recurrence within 5 years of surgery; none of the 34 patients who were MASA negative for lymph node metastasis had had a recurrence. Genetic diagnosis of lymph node metastasis may be a useful prognostic factor in colorectal cancer, and it could also serve as a selective marker for intensive postoperative adjuvant chemotherapy.

References (17)

  • J. Ovaska et al.

    Follow-up of patients operated on for colorectal carcinoma

    Am J Surg

    (1990)
  • L. Losi et al.

    Stability of K-ras mutations throughout the natural history of human colorectal cancer

    Eur J Cancer

    (1992)
  • Ga Kune et al.

    Survival in patients with large-bowel cancer

    Dis Colon Rectum

    (1990)
  • S. Takeda et al.

    Detection of K-ras mutation in sputum by mutant-allele-specific amplification (MASA)

    Hum Mutat

    (1993)
  • N. Hayashi et al.

    Genetic diagnosis identifies occult lymph node metastases undetectable by the histopathological method

    Cancer Res

    (1994)
  • O. Kronberg

    Staging and surgery for colorectal cancer

    Eur J Cancer

    (1993)
  • S. Nakatsuru et al.

    Somatic mutations of the APC gene in precancerous lesion of the stomach

    Hum Mol Genet

    (1993)
  • Y. Miyoshi et al.

    Somatic mutations of the APC gene in colorectal tumors: mutation cluster region in the APC gene

    Hum Mol Genet

    (1992)
There are more references available in the full text version of this article.

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