Detection of micrometastases in peritoneal washings of gastric cancer patients by the reverse transcriptase polymerase chain reaction Journal Article
| Authors: | Dalal, K. M.; Woo, Y.; Kelly, K.; Galanis, C.; Gonen, M.; Fong, Y.; Coit, D. G. |
| Article Title: | Detection of micrometastases in peritoneal washings of gastric cancer patients by the reverse transcriptase polymerase chain reaction |
| Abstract: | Background: Gastric cancer patients with positive (+) peritoneal cytology have a prognosis similar to stage IV patients. We studied the ability of quantitative reverse transcriptase polymerase chain reaction (RT-PCR) to detect peritoneal micrometastases in patients undergoing staging laparoscopy. Methods: Peritoneal washings were obtained prospectively from 34 patients with gastric adenocarcinoma undergoing staging laparoscopy and 6 patients undergoing laparoscopy for benign disease. Each sample underwent cytologic and RTPCR analysis for tumor markers: carcinoembryonic antigen (CEA), cytokeratin 20 (CK20), survivin, and MUC2. Markers were evaluated on the basis of their deviance from the ideal marker. Results: Pathologic stages for the gastric cancer patients were: stage I, 9 (27%); stage II, 7 (21%); stage III, 15 (44%); and stage IV, 3 (9%). The four cytology (+) patients were: stage II, 1; stage III, 1; and stage IV, 2. Fifteen patients were RTPCR (+), including all cytology (+) patients. The optimal threshold for cycle amplification was 35, based on a receiver operating characteristic curve. CEA had the smallest deviance. Conclusion: RT-PCR using a panel of tumor markers, including CEA, detects (+) cytology. The clinical significance of "false-positive" overexpression of CEA, survivin, or CK20 but cytology (-) remains to be defined. RT-PCR could represent a more sensitive method than cytology for detection of subclinical peritoneal tumor dissemination; this may be useful in improving patient selection for operative management and clinical trials. © 2008 The International Gastric Cancer Association and The Japanese Gastric Cancer Association. |
| Keywords: | adult; clinical article; controlled study; aged; aged, 80 and over; middle aged; human cell; cancer staging; neoplasm staging; laparoscopy; adenocarcinoma; cytology; reverse transcription polymerase chain reaction; peritoneal neoplasms; peritoneum lavage; carcinoembryonic antigen; tumor markers, biological; survivin; tumor marker; reverse transcriptase polymerase chain reaction; rna, messenger; micrometastasis; cytokeratin 20; keratin-20; stomach adenocarcinoma; peritoneum metastasis; stomach neoplasms; roc curve; receiver operating characteristic; gastric cancer; rt-pcr; mucin 2; micrometastases; microtubule-associated proteins; peritoneal cavity; peritoneal washings; mucin-2 |
| Journal Title: | Gastric Cancer |
| Volume: | 11 |
| Issue: | 4 |
| ISSN: | 1436-3291 |
| Publisher: | Springer |
| Date Published: | 2008-12-01 |
| Start Page: | 206 |
| End Page: | 213 |
| Language: | English |
| DOI: | 10.1007/s10120-008-0483-6 |
| PUBMED: | 19132482 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 17 November 2011" - "CODEN: GCANF" - "Source: Scopus" |
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