HematogenousMetastasisinGastriccancer.ppt

Hematogenous Metastasis in Gastric Cancer Requires Isolated Tumor Cells and Expression of Vascular Endothelial Growth Factor Receptor-1 K.Mimori1, T.Fukagawa2, Y.Kosaka1, Y.Kita1, K.Ishikawa2 T.Etoh2, H.Iinuma3, M.Sasako2, and M.Mori1 1Department of Surgical Oncology, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan 2National Cancer Center Hospital, Tokyo, Japan 3Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan Clinical Cancer Research 2008;14(9) May 2008 Introduction Isolated Tumor Cells ( ITC ) in peripheral blood(PB) or bone marrow (BM) With immunohistochemistry: ITC not related to recurrence or prognosis in gastric cancer With quantitative reverse transcription-PCR (RT-PCR)  ? predict disease-free or overall survival ? Bone marrow-derived hematopoietic progenitor cellswith vascular endothelial growth factor receptor-1(VEGFR-1) expression Home to tumor-specific premetastatic site Form cellular clusters before arrival of tumor cells(in vivo in vitro) Thus hypothesis : Metastasis of gastric cancer requires both the presence of ITC and high expression of VEGFR-1 Materials Methods Prospective blind study with large number of gastric cancer patient (n= 810) Gastric cancer cases From 2001 To 2004, Totally n=810 gastric cancer patients received operation at Central hospital, National Cancer Center, Tokyo, Japan All had documented informed consent Male : Female = 546 : 264 Average Age : 61.5 years ( Range 24 to 89 ) Hematogenous progression Site At operation 2-yr F/U Lung n=6 Liver n=5 Peritoneal Dissemination n=26 (at operation or 2-yr F/U) Tumor Stage Stage I n= 501  Stage II n= 107 Stage III n= 74 Stage IV n= 128 Normal Controls To maintain high specificity for target g