The prediction of peritoneal recurrence in colorectal cancer patients is required for improvement of prognosis. In this study, we focused on establishing a novel rapid RNA direct amplification system with transcription-reverse transcription concerted reaction (TRC) to detect carcinoembryonic antigen (CEA) mRNA in peritoneal washings, and its usefulness as a prophylactic tool for peritoneal recurrence and survival in patients with colorectal cancer. Peritoneal washes were obtained from 161 patients with colorectal cancer during laparotomy. CEA mRNA and porphobilinogen deaminase (PBGD) mRNA levels of peritoneal washes were detected using the TRC method. Genetic detection in the CEA mRNA of peritoneal washes by TRC showed a significant correlation to the depth of invasion, lymphatic invasion, venous invasion, lymph node metastasis, peritoneal dissemination and stage. The overall survival and peritoneal recurrence-free survival rates of CEA mRNA-positive patients were significantly poorer than those of marker gene-negative patients. CEA mRNA levels in peritoneal washes were a significant independent prognostic factor for overall survival and peritoneal recurrence-free survival. In conclusion, our study demonstrated that the detection of CEA mRNA in peritoneal washings by TRC is a useful, rapid genetic diagnosis for the prediction of peritoneal recurrence and survival in patients with colorectal cancer.

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