Background/aims: To comprehensively understand the influence of laparoscopic resection on expressions of metastasis related genes in colorectal cancer by microarray.
Methodology: Adjacent cancer tissues were obtained from the same patient with rectal cancer pre and post laparoscopic resection. The mRNA expressions of metastasis related genes were detected by GEArray Q Series human tumor metastasis gene array HS-007. The microarray results were verified by real-time PCR. Preclinical studies focusing on the effect of CO2 pneumoperitoneum on colorectal cancer metastasis over the last ten years were reviewed.
Results: Microarray analysis revealed that the expression of many metastasis related genes changed significantly post laparoscopic operation. Several metastatic mechanisms were activated including extracellular matrix degradation, cell adhesion, inflammation and angiogenesis. Meanwhile, some well known metastasis inhibition pathways were also activated, including NM23, PTEN and Thrombospondin. In the literature review there were inconsistent findings among reported experimental studies in terms of the effect of CO2 pneumoperitoneum on colorectal cancer metastasis.
Conclusions: This microarray finding implies that laparoscopic resection produced no overwhelming adverse effect on the expressions of metastasis related genes in colorectal cancer. In view of the increasing follow-up results from a number of clinical trials, laparoscopic surgery with CO2 pneumoperitoneum appears to be safe.