Year 2023 Vol. 31 No 4

SCIENTIFIC PUBLICATIONS

A.V. OREKHVA 1, 2, E.A. SHLIAKHTUNOV 2, I.V. ZHILTSOV 2, V.M. SEMENOV 2, E.V. KARCHMIT 1, G.M. SHAPPO 2, , J.N. LYACH 1, A.V. OREKHVA 3

MONITORING OF MINIMAL RESIDUAL DISEASE IN COLORECTAL CANCER BASED ON THE ASSESSMENT OF SURVIVIN (BIRC5) MRNA EXPRESSION IN CIRCULATING TUMOR CELLS

Health Institution "Vitebsk Regional Clinical Oncology Dispensary" 1,
Educational Establishment "Vitebsk State Medical University" 2,
Health Institution "Vitebsk Regional Clinical Diagnostic Center” 3, Vitebsk,
Republic of Belarus

Objective. To assess the clinical significance of survivin (BIRC5) mRNA expression in circulating tumor cells (CTCs) in colorectal cancer (CRC).
Methods. The study involved 130 patients (109 patients with colorectal cancer and 21 patients with colon adenomas). All patients underwent complete tumor resection (radical surgery – 102 (93.6%), cytoreductive – 7 (6.4%)). Monitoring of survivin mRNA (BIRC5) expression in the CTC was performed within 9 months after surgery. The expression study was performed using RT-PCR, the normalized expression of the BIRC5 gene in the CTCs was examined.
Results. A high level of survivin (BIRC5) mRNA expression was found in CTCs in CRC compared to adenomas (p<0.001), both prior surgery M±SD (1.175±1.33 and 0.052±0.11) and after 3 months M±SD (1.015±0.93 and 0.018±0.002). A relationship was found between the presence of CTCs in patients prior surgery and damage of regional lymph nodes (p=0.032), stage of the tumor process (p=0.011), tumor size (p=0.038), degree of tumor differentiation (p=0.039), positive expression of survivin mRNA ( BIRC5) in tumor material (p=0.044) . In 6 and 9 months after surgery, CTCs persist in the bloodstream, even despite adjuvant chemotherapy in patients with stage III disease (p=0.015 and p=0.012).
Conclusion. Survivin is a highly sensitive tumor marker in CRC due to its overexpression in the CTC. Overexpression of survivin mRNA in CRC has been identified as negative prognostic factor and directly depends on the tumor lesion of the regional lymph nodes, the stage of the disease, the degree of tumor differentiation, and the size of the tumor. In 9 months after radical surgery determination of survivin (BIRC5) mRNA expression in the CTC can be used for assessment of minimal residual disease and considered as a powerful prognostic factor of the overall survival rate.

Keywords: BIRC5, survivin, minimal residual disease, circulating tumor cells, colorectal cancer
p. 322-331 of the original issue
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Address for correspondence:
210009, Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical Univercity.
tel.: +375-33-900-44-00,
e-mail: dr.orehva@yandex.ru,
Orekhva Andrey V.
Information about the authors:
Orekhva Andrey V., Oncologist-Surgeon of the Oncological Abdominal Department of Vitebsk Regional Clinical Oncological Dispensary, Applicant for the Department of Oncology with Courses of LD, LT, FPC and PC. Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-9145-4216
Shlyakhtunov Evgenij A., MD, Associate Professor, Head of the Department of Oncology with Courses of LD, LT, FPC and PC Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-5906-5373
Semenov Valery M., MD, Professor, Head of the Department of Infectious Diseases, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-7029-9226
Zhiltsov Ivan V., MD, Professor, Head of the Department of Evidence-Based Medicine and Clinical Diagnostics FPC and PC, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-4912-2880
Shappo Galina M., PhD, Associate Professor of the Department of Oncology with Courses of LD, LT, FPC and PC Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-2147-3937
Lyakh Yan N., Oncologist of the Oncological Polyclinic Department of the Vitebsk Regional Clinical Oncological Dispensary, Vitebsk, Republic of Belarus.
https://orcid.org/0009-0001-2385-4880
Karchmit Evgenia V., Head of the Oncological Polyclinic Department of Vitebsk Regional Clinical Oncological Dispensary, Vitebsk, Republic of Belarus.
https://orcid.org/0009-0009-0231-7945
Orekhva Alina V., Radiologist of the Department of Radiation Diagnostics of Vitebsk Regional Clinical Diagnostic Center, Vitebsk, Republic of Belarus.
https://orcid.org/0009-0007-4484-6736
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