Tumour cell dissemination following endoscopic stent insertion

Area of Science:

• Oncology
• Gastroenterology
• Molecular Diagnostics

Background:

• Colorectal cancer (CRC) management involves procedures like colonoscopy and stent insertion.
• Assessing tumor markers in peripheral circulation is crucial for CRC monitoring.
• Carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) mRNA are potential biomarkers.

Purpose of the Study:

• To investigate the impact of colonoscopy and endoscopic colonic stent insertion on circulating CEA and CK20 mRNA levels in CRC patients.
• To determine if these procedures cause transient increases in specific mRNA biomarkers.

Main Methods:

• Peripheral venous blood samples were collected from CRC patients before and after colonoscopy or stent insertion.
• A control group of patients undergoing colonoscopy for benign conditions was included.
• Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) was used to quantify mRNA expression.

Main Results:

• Cytokeratin 20 (CK20) mRNA was detected in patients undergoing both procedures, but not in controls.
• Stent insertion led to a statistically significant increase in CK20 mRNA levels (P = 0.007).
• Colonoscopy did not significantly alter CK20 mRNA levels (P = 0.454), and CEA mRNA changes were minimal.

Conclusions:

• Endoscopic colonic stent insertion, but not diagnostic colonoscopy, increases peripheral CK20 mRNA levels in colorectal cancer patients.
• This finding suggests a potential procedural effect on circulating tumor-associated mRNA.
• Further research may explore the clinical significance of these transient mRNA changes.