Gastric Cancer

, Volume 11, Issue 4, pp 206–213

Detection of micrometastases in peritoneal washings of gastric cancer patients by the reverse transcriptase polymerase chain reaction

  • Kimberly Moore Dalal
  • Yanghee Woo
  • Kaitlyn Kelly
  • Charles Galanis
  • Mithat Gonen
  • Yuman Fong
  • Daniel G. Coit
Original Article

DOI: 10.1007/s10120-008-0483-6

Cite this article as:
Dalal, K.M., Woo, Y., Kelly, K. et al. Gastric Cancer (2008) 11: 206. doi:10.1007/s10120-008-0483-6

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.

Key words

Gastric cancer Peritoneal washings Cytology Micrometastases RT-PCR 
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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2008

Authors and Affiliations

  • Kimberly Moore Dalal
    • 1
    • 2
    • 3
  • Yanghee Woo
    • 1
  • Kaitlyn Kelly
    • 1
  • Charles Galanis
    • 1
  • Mithat Gonen
    • 4
  • Yuman Fong
    • 1
  • Daniel G. Coit
    • 1
  1. 1.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of SurgeryDavid Grant U.S. Air Force Medical CenterTravis AFBUSA
  3. 3.Department of SurgeryUniversity of California at San FranciscoSan FranciscoUSA
  4. 4.Department of Epidemiology and BiostatisticsMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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