Detection of survivin-expressing circulating cancer cells (CCCs) in peripheral blood of patients with gastric and colorectal cancer reveals high risks of relapse

Ann Surg Oncol. 2008 Nov;15(11):3073-82. doi: 10.1245/s10434-008-0069-x. Epub 2008 Aug 1.


Background: We previously demonstrated that the detection of circulating cancer cells (CCCs) expressing survivin mRNA could provide valuable information for predicting metastasis and recurrence in breast cancer. The objective of this study was to investigate whether or not the detection of survivin expression in the peripheral blood could also have significant effects on the clinical outcomes of patients with gastric and colorectal cancer.

Methods: Survivin-expressing CCCs in peripheral blood samples obtained from 55 gastric cancer patients, 86 colorectal cancer patients, and 87 healthy volunteers were quantitatively examined by using a RT-PCR ELISA. Its clinical significance was statistically evaluated.

Results: The CCCs in the peripheral blood samples were detected in 45.4% and 44.0% of gastric and colorectal cancer patients, respectively. The presence of survivin-expressing CCCs was found to be significantly associated with the degree of tumor penetration, nodal status, and disease stages for both types of cancers. During a follow-up period of 36 months, patients who had a positive detection at the time of the initial assay test had a higher relapse rate than those who had a negative detection. As well, survivin-expressing CCCs were statistically shown to be a significant and independent predictor for cancer recurrence. The detection of survivin-expressing CCCs was also demonstrated to be more accurate in terms of predicting recurrence than traditional detection methods such as plasma carcinoembryonic antigen (CEA) measurements.

Conclusion: The detection of CCCs expressing survivin mRNA could be used to accurately identify gastric and colorectal cancer patients with high risks of relapse.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood
  • Biomarkers, Tumor / genetics
  • Carcinoembryonic Antigen / blood
  • Case-Control Studies
  • Colorectal Neoplasms / blood*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / secondary
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Inhibitor of Apoptosis Proteins
  • Lymphatic Metastasis
  • Male
  • Microtubule-Associated Proteins / blood*
  • Microtubule-Associated Proteins / genetics
  • Middle Aged
  • Neoplasm Recurrence, Local / blood*
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Neoplastic Cells, Circulating / pathology*
  • Prognosis
  • RNA, Messenger / blood*
  • RNA, Messenger / genetics
  • RNA, Neoplasm / blood*
  • RNA, Neoplasm / genetics
  • Reverse Transcriptase Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / secondary
  • Survivin


  • BIRC5 protein, human
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Inhibitor of Apoptosis Proteins
  • Microtubule-Associated Proteins
  • RNA, Messenger
  • RNA, Neoplasm
  • Survivin