Original CommunicationsNo-touch isolation technique reduces intraoperative shedding of tumor cells into the portal vein during resection of colorectal cancer☆,☆☆
Section snippets
Patients
All patients were thoroughly informed about the study and gave written consent for investigation in accordance with the ethical guidelines of our university. Twenty-seven patients with colorectal cancer who underwent surgery at the Department of Surgery II, Kumamoto University Hospital, or at the Department of Surgery, Kumamoto Central Hospital, Kumamoto, Japan, were included in our study. Conventional operation was performed in 17 cases: cecal lesions (n = 3), ascending colon (n = 1),
Results
We initially performed the conventional method as a standard operation for patients with colorectal cancer. Seventeen patients who underwent operation by the conventional method were studied to examine tumor cell dissemination into the portal vein by manipulation during operation. In each of the primary tumors we looked for somatic mutations in selected regions of the K-ras or p53 genes. We used MASA9 to examine mutations at codons 12, 13, and 61 of K-ras . PCR reactions with MASA primers that
Discussion
Hematogenous spread of tumor cells seems to influence the outcome of the disease for most cancer patients. However, little is known about the nature of this process. Because the number of tumor cells in blood is very small, techniques for their detection need to be not only highly sensitive but also specific.
The advent of PCR has made an enormous impact on nucleic acid analysis.15 PCR-based techniques have improved the sensitivity of detection systems for disseminated tumor cells. Reverse
Acknowledgements
We thank the physicians in the Department of Surgery II, Kumamoto University Medical School, Kumamoto, and the Department of Surgery, Kumamoto Central Hospital, Kumamoto, for providing appropriate tissue samples.
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Supported in part by a Grant-in Aid from the Ministry of Education, Culture, and Science of Japan and by a grant from the Japanese Society for Advancement of Surgical Technique.
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Reprint requests: Michio Ogawa, MD, PhD, Department of Surgery II, Kumamoto University Medical School, Honjo 1-1-1, Kumamoto 860-0811, Japan.