Detection of the biomarker, guanylyl cyclase 2C (GUCY2C), indicates the presence of occult metastases in lymph nodes that may not have been identified by current cancer staging methods, according to Scott Waldman, M.D., Ph.D., chairman of the Department of Pharmacology and Experimental Therapeutics at Jefferson Medical College of Thomas Jefferson University.
According to Dr. Waldman, who is also the Samuel M.V. Hamilton Professor of Clinical Pharmacology in the Department of Medicine at Jefferson Medical College, colorectal cancer that has metastasized, or spread, to the regional lymph nodes carries a worse prognosis and a higher risk for recurrence. However, these metastases are often missed, and the cancer is understaged.
"One of the unmet needs in colorectal cancer is an accurate staging method to determine how far the disease has spread," said Dr. Waldman, who is also director of the Gastrointestinal Malignancies Program at the Kimmel Cancer Center at Jefferson. "The current standard method, histopathology, is imperfect since it only involves looking at a very small sample of the regional lymph nodes under a microscope. There is no way to know whether occult metastases are present in the rest of the tissue."
Dr. Waldman and his colleagues conducted a prospective, multicenter study of 257 patients with colorectal cancer that had no metastases identified in the lymph nodes (node-negative) according to current standards. They analyzed the lymph nodes for GUCY2C expression using a technique called reverse transcriptase-polymerase chain reaction (RT-PCR). This technique, according to Dr. Waldman, amplifies the sensitivity to detect cancer cells compared to histopathology.
The majority of patients – 87.5 percent – had lymph nodes that were positive for GUCY2C. Among those patients, 20.9 percent developed recurrent disease. By comparison, only 6.3 percent of the patients whose lymph nodes were negative for GUCY2C developed recurrent disease.
The patients were followed for a median of 24 months for disease recurrence or death. Indeed, patients who expressed GUCY2C had a shorter time to recurrence and a shorter disease-free survival. The prognostic value of the marker persisted even after a multivariate analysis that took other known prognostic factors into account.
According to Dr. Waldman, 20 to 30 percent of patients diagnosed with node-negative colorectal cancer experience disease recurrence within five years. This is approximately the same rate of recurrence as that for some categories of patients diagnosed with node-positive disease. These observations suggest that there are occult metastases in the lymph nodes of node-negative patients at the time of diagnosis. GUCY2C specifically identifies these occult metastases that indicate risk for recurrent disease.
"Beyond predicting disease recurrence, detecting this biomarker could be useful for identifying patients who might benefit from treatment with adjuvant chemotherapy, which is specifically given to patients with node-positive disease," Dr. Waldman said.
Emily Shafer | EurekAlert!
Climate Impact Research in Hannover: Small Plants against Large Waves
17.08.2018 | Leibniz Universität Hannover
First transcription atlas of all wheat genes expands prospects for research and cultivation
17.08.2018 | Leibniz-Institut für Pflanzengenetik und Kulturpflanzenforschung
New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference
Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...
Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...
Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.
When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...
Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.
Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....
Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.
Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...
17.08.2018 | Event News
08.08.2018 | Event News
27.07.2018 | Event News
17.08.2018 | Physics and Astronomy
17.08.2018 | Information Technology
17.08.2018 | Life Sciences