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Persistence of Epidermal Growth Factor Receptor and Interleukin 10 in Blood of Colorectal Cancer Patients after Surgery Identifies Patients with High Risk to Relapse¹

Dipartimento di Scienze Chirurgiche, Policlinico Umberto I [L. G., C. B., A. F.], Rome; INRCA, Unità Operativa Oncologica, Sede di Roma [W. G., L. R.], Rome; and Dipartimento di Medicina Sperimentale e Patologia, Università degli Studi di Roma, "La Sapienza," 324 00161 Rome [O. G., L. R., L. F., A. A., P. G.], Italy

Purpose: Despite the great number of studies performed to detect circulatingmarkers of disease progression in colorectal cancer, few have shown a clinical use; among those, epidermal growth factor receptor (EGFR) and, more recently, interleukin (IL)-10. In this article, we sought to investigate how primary surgery could affect expression levels of EGFR, IL-6, and IL-10 in blood from colorectal cancer patients.

Experimental Design: We investigated by reverse transcriptase-PCR assay the expression at mRNA level of EGFR, IL-6, and IL-10 in blood samples taken from 56 colorectal cancer patients. Each gene expression was evaluated 1 day before and 20 days after primary surgery. Persistence of each gene in blood after surgery was then correlated to the relapse free time in a follow-up of 3 years.

Results: In blood samples taken before surgery, EGFR, IL-6, and IL-10 were found expressed in 62, 100, and 100% of patients, respectively. EGFR expression, but not IL-6 and IL-10, correlates with stage of disease. In the group of 41 patients who underwent follow-up studies, EGFR was found persistently high in 67%; 94% of them had relapse. Persistence of IL-10 after surgery also identifies relapses in 89% of cases. IL-6 persistence was not found to significantly correlate to progression of disease.

Conclusions: Persistence of both EGFR and IL-10 in blood of colorectal cancer patients after surgery identifies patients with high propensity to relapse. These findings may suggest a clinical use of preoperative EGFR/IL-10 reverse transcriptase-PCR assay in the prediction of tumor recurrence.