Gastric Cancer

, Volume 8, Issue 3, pp 142–148 | Cite as

Prognostic significance of intraperitoneal cancer cells in gastric carcinoma: detection of cytokeratin 20 mRNA in peritoneal washes, in addition to detection of carcinoembryonic antigen

  • Yasuhiro Kodera
  • Hayao Nakanishi
  • Seiji Ito
  • Yoshitaka Yamamura
  • Michitaka Fujiwara
  • Masahiko Koike
  • Kenji Hibi
  • Katsuki Ito
  • Masae Tatematsu
  • Akimasa Nakao
Original article



In patients with gastric cancer, the presence of gastric cancer cells in the peritoneal cavity detected by cytologic examination, is a significant prognostic factor. A more sensitive, reverse transcriptase-polymerase chain reaction (RT-PCR) technique, amplifying carcinoembryonic antigen (CEA), was introduced as a new detection system, but produced some false-positive results. A search for other molecular markers is ongoing.


Peritoneal washes were obtained from 195 patients with gastric carcinoma during surgery. Cytokeratin 20 (CK20) mRNA levels were quantified, in addition to those of CEA, using the LightCycler, and the feasibility of CK20 as a target was evaluated.


CK20 was limited, in terms of sensitivity, for detecting disseminated cancer cells (sensitivity, 63%; specificity, 91%; positive predictive value, 70%; and negative predictive value, 88%). Multimarker analysis was performed, in which samples positive for either CK20 or CEA mRNA were considered to be positive for cancer cells. Multivariate analysis identified the multimarker analysis as a significant independent prognostic determinant.


CK20 RT-PCR produced information that could add a significant impact to the knowledge obtained by CEA RT-PCR, although detection by CK20 alone was not sufficiently sensitive to replace CEA in the detection system.

Key words

Peritoneal carcinomatosis Cytology Micrometastasis RT-PCR 


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Copyright information

© International and Japanese Gastric Cancer Association 2005

Authors and Affiliations

  • Yasuhiro Kodera
    • 1
  • Hayao Nakanishi
    • 2
  • Seiji Ito
    • 3
  • Yoshitaka Yamamura
    • 3
  • Michitaka Fujiwara
    • 1
  • Masahiko Koike
    • 1
  • Kenji Hibi
    • 1
  • Katsuki Ito
    • 1
  • Masae Tatematsu
    • 2
  • Akimasa Nakao
    • 1
  1. 1.Second Department of SurgeryNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Laboratory of PathologyAichi Cancer Center Research InstituteNagoyaJapan
  3. 3.Department of Gastroenterological SurgeryAichi Cancer Center HospitalNagoyaJapan

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