Impact of endoscopic stent insertion on detection of viable circulating tumor cells from obstructive colorectal cancer

Yamashita,Shinya; Tanemura,Masahiro; Sawada,Genta; Moon,Jeongho; Shimizu,Yosuke; Yamaguchi,Toshiki; Kuwai,Toshio; Urata,Yasuo; Kuraoka,Kazuya; Hatanaka,Nobutaka; Yamashita,Yoshinori; Taniyama,Kiyomi

doi:10.3892/ol.2017.7339

Impact of endoscopic stent insertion on detection of viable circulating tumor cells from obstructive colorectal cancer

Authors:
- Shinya Yamashita
- Masahiro Tanemura
- Genta Sawada
- Jeongho Moon
- Yosuke Shimizu
- Toshiki Yamaguchi
- Toshio Kuwai
- Yasuo Urata
- Kazuya Kuraoka
- Nobutaka Hatanaka
- Yoshinori Yamashita
- Kiyomi Taniyama
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Affiliations: Department of Surgery, Nissay Hospital, Osaka 565‑0871 Japan, Department of Gastroenterological Surgery, Osaka Police Hospital, Osaka 543‑0035, Japan, Department of Surgery, Sakai Medical Center, Osaka 593‑8304, Japan, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537‑8511, Japan, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima 737‑0023, Japan, Oncolys BioPharma, Inc., Tokyo 106‑0032, Japan, Department of Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka 553‑0003, Japan
Published online on: November 2, 2017 https://doi.org/10.3892/ol.2017.7339
Pages: 400-406

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Abstract

The placement of a self-expanding metallic stent (SEMS) in obstructive colorectal cancer (OCRC) is acknowledged to be a safe and effective procedure for the relief of obstruction. However, there is concern that shear forces acting on the tumor during stent expansion may release cancer cells into the circulation, resulting in a poor prognosis. The aim of the present study was to determine whether colonic stent insertion increases viable circulating tumor cells (v‑CTCs). A telomerase‑specific replication‑selective adenovirus‑expressing GFP (TelomeScanF35) detection system was used to detect v‑CTCs in 8 OCRC patients with a SEMS before and after stent insertion and after surgical resection. In 7 patients, a SEMS was inserted as a bridge to surgery (BTS), and in one patient, a SEMS was inserted for palliation. Surgical resection (R0) was performed in 7 patients. Four patients had no v‑CTCs before SEMS placement, two of four measurable patients had an increased number of v‑CTCs after SEMS placement (1‑3 v‑CTCs), and one of two patients with increased v‑CTCs developed distant lymphatic metastasis despite curative resection. Four patients had v‑CTCs (1‑19 cells) before SEMS placement, and two of these four patients had an increase in the number of v‑CTCs (20‑21 cells) after SEMS placement, while one of the four patients died early with distant metastasis. The present study demonstrated that endoscopic stent insertion for OCRC may result in tumor cell dissemination into the peripheral circulation and may induce distant metastases.

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