Back to Annual Meeting Posters

Background: Recurrence of colorectal cancer (CRC) following a potentially curative resection is a major challenging clinical problem. Although detection of tumoral cells within the peritoneal cavity at the time of surgery has been proposed as useful tool to identify patients with recurrent CRC, the overall low sensitivity of the test has hampered its use in the management of such patients. Matrilysin, also termed matrix metalloproteinase (MMP)-7, is over-expressed by CRC cells and supposed to play a major role in CRC cell diffusion and metastasis. This study was aimed at determining whether MMP-7 is detectable in the peritoneal cavity of CRC patients undergoing potentially curative resection and assessing whether MMP-7 positivity marks patients who experience CRC recurrence.
Material and Methods: Fifty-seven colorectal cancer patients undergoing elective colorectal resection were prospectively enrolled from June 2009 to November 2011. During the surgery, peritoneal cavity was flushed with cold saline solution and fluid was then harvested and used for RNA extraction. MMP-7 RNA expression was assessed by RT-PCR using specific primers. After surgery, patients underwent a regular follow up (range 12-26 months) for assessing recurrence.
Results: Two patients were lost during the follow up. RNA transcripts for MMP-7 were detected in 31/57 samples (54%). Recurrence was diagnosed in 6 out of 55 patients (11%); 4 patients eventually died because of metastases or peritoneal dissemination. All the 6 patients who had relapsed were positive for MMP-7. Sensitivity and specificity of the test were 100% and 49% respectively.
Conclusions: Positivity of MMP-7 in peritoneal cavity samples could be a novel biomarker for predicting disease recurrence in patients with CRC.