| Objective: Colorectal cancer is a common malignant disease, although earlier colorectal cancer patients having underwent curative resection, whose prognosis did not improve evidently. There has been report that approximately 30% of those died of recurrence and metastasis. Therefore, we might guess that earlier colorectal cancer patients have occurred micrometastasis. Whether or not of lymph node occurring micrometastasis predicted clinical prognosis. Survival rate of patients with lymph node micrometastasis was lower than that without. How we could detect earlier colorectal cancer micromatastasis was a important problem. Routine pathological method can not detect micrometastasis in regional lymph nodes . If using more sensitive molecular detection, we would find those patients who had metastasis proclivity earlier and adopt efficiently remedial measure in time, whose survival rate would enhance. Additional, the surgical manipulation mechanically stimulated tumor tissue in tumor operation, which would accelerate tumor cells into blood, we should master "no-touch" isolation technique. In our studying, we detected specimen obtained from colorectal cancer patients by RT-PCR and hope findmicrometastsis which might occur, which would benefit selecting of clinical therapy.METHODS : Collecting those colorectal carcinoma patients who accepted operation therapy in HEBEI University Fourth Hospital Surgery during October/2000 to April/2001, including 31 colorectal carcinoma of Dukes A, B,C,D stage patients aged 38 to 76 years were experimental group, we detected their regional lymph nodes and peripheral blood. Colorectal cancer SW480 cell lines was positive control group. As a negative control group, we analyzed five patients with non-cancerous intestinal disease and also five healthy volunteers, detecting benign disease tissue of non-cancerous intestinal disease and peripheral blood of healthy volunteers. Using reverse-transcription polymerase chain reaction(RT-PCR) detection method analyzed CD44v and CK20 of peripheral blood and regional lymph nodes. We defined RT-PCR positive as the situation where both CD44v and CK20 were positive. At the same time, we detected regional lymph nodes using routine pathological method. Using statistic method, we compared 1 .Regional lymph node results of RT-PCR with those of routine pathology.2. Results of peripheral blood obtained before operation with those of regional lymph nodes.3. Results of Dukes A and B peripheral blood specimen obtained before operation with those of Dukes C and D .RESULT: l.A stage: 3 patients.9 lymph nodes. Not only using RT-PCR method but also routine pathological method, results of all 9 lymph nodes were negative. B stage: 15 patients.45 lymph nodes. Twelve of 45 lymph nodes were RT-PCR positive and eight of 15 patients were RT-PCR positive. All 45 lymph nodes were routine pathological negative. C stage: 10 patients.30 lymph nodes.Twenty of 30 lymph nodes were routine pathological positive and twenty four of 30 lymph nodes were RT-PCR positive including all 20 routine pathological positive lymph nodes. All of 10 patients were RT-PCR positive. D stage: 3 patients.9 lymph nodes.Seven of 9 lymph nodes were not only RT-PCR but also routine pathological positive. All of 3 patients were RT-PCR positive. Twenty seven of all 93 lymph nodes were routine pathological positive.43 lymph nodes were RT-PCR positive, including all 27 routine pathological positive lymph nodes. RT-PCR was more sensitive than routine pathological method (p=0.0001). 2.Seven of 31 peripheral blood specimens were RT-PCR positive before surgical manipulation, two showed a change of PCR from negative to positive during surgery. Surgery manipulation might enhance release of tumor cells into the circulation. 3. That metastasis occurred in lymph node was earlier than peripheral blood (p=0.0001). 4. Advanced colorectal cancer released tumor cells more than earlier colorectal cancer (p=0.012). 5.Lymph node and/or peripheral blood specimenof five patients with non-cancerous intestinal...
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