The cell adhesion molecule, E‐cadherin, distinguishes mesothelial cells from carcinoma cells in fluids

Schofield, Kevin; D'Aquila, Thomas; Rimm, David L.

doi:10.1002/(sici)1097-0142(19971025)81:5<293::aid-cncr7>3.3.co;2-c

Cited by 18 publications

(29 citation statements)

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“…IFCC detection by conventional cytology has been the gold standard to date, and this method has been included in the JGCA [13]. Cytology has, however, been criticized for its low sensitivity and the interpretive challenge of differentiating well-differentiated carcinoma cells from benign mesothelial cells [17,18]. Sensitivities for cytology can vary greatly among institutions because of pathologists' experience, inter-observer variability, and the diagnostic criteria used [30].…”

Section: Discussionmentioning

confidence: 99%

“…Low sensitivity and a poor negative predictive value of this method have heralded the development of advanced techniques in detecting IFCCs-immunoassays, immunohistochemistry (IHC), and reverse transcriptase-polymerase chain reaction (RT-PCR). It has been suggested that these tools have better sensitivity in detecting IFCCs with better correlation to peritoneal recurrence [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

et al. 2011

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Background There is lack of uniformity in the utilization of peritoneal cytology in gastric cancer management. The identification of intraperitoneal free cancer cells (IFCCs) is believed to confer poor prognosis. However, while some of these patients are palliated, others may undergo more aggressive therapies. In this review, we aimed to identify and synthesize findings on the use of peritoneal cytology in predicting peritoneal recurrence and overall survival in curative gastric cancer patients. Methods Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 31, 2009. We determined the accuracy, sensitivity, and specificity of peritoneal cytology in predicting peritoneal recurrence based on four techniques-conventional cytology, immunoassay, immunohistochemistry, and reverse transcriptase-polymerase chain reaction. Recurrence rates and overall survival rates for curative patients were determined, based on positivity or negativity for IFCCs. Results Twenty-eight articles were included. All four techniques showed wide variations in accuracy, sensitivity, and specificity in predicting peritoneal recurrence. Recurrence rates for patients positive for IFCCs ranged from 11.1 to 100%, while those negative for IFCCs had recurrence rates of 0-51%. Overall survival was significantly reduced for patients with positive IFCCs. Short follow-up periods and possible duplication of results may limit result interpretation. Conclusion The presence of IFCCs appears to increase the risk of peritoneal recurrence and is associated with worse overall survival in gastric cancer patients. Further incorporation of peritoneal cytology in clinical decisionmaking in gastric cancer depends on the development of a consistently accurate and rapid IFCC detection method.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

et al. 2011

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“…However, by the conventional cytology, patients with negative cancer cells have occasionally developed recurrent peritoneal disease after surgery, which thus resulted in a low sensitivity of the cytology (Boku et al, 1990;Abe et al, 1995;Schofield et al, 1997;de Manzoni et al, 2006). Almost half of all patients with serosa-invading gastric carcinoma experience peritoneal recurrence even after a curative surgical resection (Martin et al, 2002;Tsuburaya et al, 2005).…”

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confidence: 99%

Prognostic impact of PCR-based identification of isolated tumour cells in the peritoneal lavage fluid of gastric cancer patients who underwent a curative R0 resection

et al. 2007

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Identification of cancer cells in the peritoneal cavity could influence therapy and outcome of gastric carcinoma patients. The objective of this study was to evaluate the clinical impact of the real-time quantitative polymerase chain reaction-(PCR) based identification of isolated tumour cells in the peritoneal lavage fluid of gastric carcinoma. The peritoneal lavage fluid of 116 patients with gastric cancer was sampled at laparotomy. After RNA extraction and reverse transcription, real-time quantitative PCR was performed using the primers and probes for carcinoembryonic antigen (CEA) and cytokeratin-20 (CK20). When either the CEA mRNA or CK20 mRNA level of the sample was over the cutoff value, the sample was determined to be PCR-positive. Forty-six (40%) of the 116 patients were PCR-positive and 30 (65%) of the 46 PCR-positive patients died as a result of recurrent peritoneal dissemination. The prognosis of the 46 PCR-positive patients was significantly (Po0.001) worse than that of 70 PCR-negative patients. Furthermore, in 80 of the cases with a curative R0 resection, 15 of the patients with PCR-positive findings had a significantly (Po0.001) poorer prognosis than the 65 PCR-negative patients. The prognosis of the PCR-positive patients was significantly poorer than that of the PCR-negative patients in the T3 (Po0.0001) and T4 (P ¼ 0.048) subgroups. In a multivariate analysis of the 80 cases with a curative R0 resection, the real-time quantitative RT -PCR (CEA and/or CK20) levels indicated that they were independent prognostic factors. The real-time quantitative RT -PCR analysis of the CEA and/or CK20 transcripts in the peritoneal lavage fluid is useful for predicting the peritoneal recurrence in patients who are undergoing a curative resection for gastric cancer.

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“…We obtained similar results in our study -in cases of R0 resection, positive cytology was obtained in 5 of 34 patients (14.7%), in cases with coexisting peritoneal metastases -in 4 of 10 (40%) of patients. Limitations of this method are related to low sensitivity and interpretational problems in differentiation between well differentiated tumor cells and benign mesothelial cells (17,18).…”

Section: Resultsmentioning

confidence: 99%

Analysis Of Risk Factors Of Positive Peritoneal Cytology In Patients Treated For Gastric Cancer – Preliminary Report*

Lisiecki¹,

Spychała²,

Pater³

et al. 2015

Polish Journal of Surgery

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Presence of free gastric cancer cells in the peritoneal cavity of patients who underwent surgical treatment for gastric cancer is a negative prognostic factor and caused rapid disease recurrence, manifested as peritoneal metastases. Positive peritoneal cytology despite lack of visible peritoneal metastases was regarded as M1 class in the TNM classification (7 th edition) in 2010. the aim of the study was to analyze factors associated with positive peritoneal cytology and identify groups of patients in whom diagnostic laparoscopy plus peritoneal lavage in the diagnostic process could affect therapeutic decisions. material and methods. The study enrolled patients with gastric cancer who underwent surgical treatment at the Department of Surgery, Wielkopolskie Oncology Center in Poznań. During the laparotomy, after opening of the peritoneal cavity, 200 ml of physiological saline at 37°C was administered in the tumor region. After this fluid was mixed, 100 ml of lavage fluid was collected. This fluid was subsequently spun many times to obtain sediment for cytology and immunohistochemistry investigation using anti-BerEp-4, CK 7/20, and B72.3. Results of peritoneal cytology were analyzed jointly with clinical factors -patient's age, sex and pathology factors -tumor invasion, involvement of lymph nodes, histological grade, histological type according to Lauren and localization of the cancer in the stomach. Results. Analysis of the peritoneal fluid for presence of free cancer cells was done in 51 patients. Positive peritoneal cytology was found in 12 (23.5%) patients. In the group of patients with positive cytology, all patients had T3/T4 tumors and all were found to have lymph node metastases, while G3 cancer was found in 83.3% of patients. In patients with positive cytology, diffuse gastric cancer according to Lauren predominated (9 of 12 patients, 75%), while in patients with negative cytology -intestinal type (20 of 39 patients, 51.2%). In the group of patients with positive histology, the whole stomach was involved by the cancer process in 7 of 12 patients (58.3%), while in the group with negative histology, in 29 of 39 patients the tumor was located in the gastric body and prepyloric part (74.4%). conclusions. Based on this study we can conclude that determinants of positive peritoneal cytology include: tumor stage T3/T4, N+, G3, cancer located in the whole stomach, diffuse histological type according to Lauren.

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The cell adhesion molecule, E‐cadherin, distinguishes mesothelial cells from carcinoma cells in fluids

Cited by 18 publications

References 0 publications

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

Prognostic impact of PCR-based identification of isolated tumour cells in the peritoneal lavage fluid of gastric cancer patients who underwent a curative R0 resection

Analysis Of Risk Factors Of Positive Peritoneal Cytology In Patients Treated For Gastric Cancer – Preliminary Report*

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