Abstract
Background
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.
Methods
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.
Results
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.
Conclusion
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.
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References
CH Yoo SH Noh DW Shin SH Choi JS Min (2000) ArticleTitleRecurrence following curative resection for gastric carcinoma Br J Surg 87 236–42 Occurrence Handle10.1046/j.1365-2168.2000.01360.x Occurrence Handle10671934
Y Maehara S Hasuda T Koga E Tokunaga Y Kakeji K Sugimachi (2000) ArticleTitlePostoperative outcome and sites of recurrence in patients following curative resection of gastric cancer Br J Surg 87 353–7 Occurrence Handle10.1046/j.1365-2168.2000.01358.x Occurrence Handle10718807
S Koga N Kaibara Y Iitsuka H Kudo A Kimura H Hiraoka (1984) ArticleTitlePrognostic significance of intraperitoneal free cancer cells in gastric cancer patients J Cancer Res Clin Oncol 108 236–8 Occurrence Handle10.1007/BF00402474 Occurrence Handle6470030
T Boku Y Nakane T Minoura H Takeda M Yamamura K Hioki et al. (1990) ArticleTitlePrognostic significance of serosal invasion and free intraperitoneal cancer cells in gastric cancer Br J Surg 77 436–9 Occurrence Handle2340396
JJ Bonenkamp I Songun J Hermans CJ van de Velde (1996) ArticleTitlePrognostic value of positive cytology findings from abdominal washings in patients with gastric cancer Br J Surg 83 672–4 Occurrence Handle8689216
Y Kodera Y Yamamura Y Shimizu A Torii T Hirai K Yasui et al. (1999) ArticleTitlePeritoneal washing cytology: prognostic value of positive findings in patients with gastric carcinoma undergoing a potentially curative resection J Surg Oncol 72 60–5 Occurrence Handle10.1002/(SICI)1096-9098(199910)72:2<60::AID-JSO3>3.0.CO;2-1 Occurrence Handle10518099
N Hayes J Wayman V Wadehra DJ Scott SA Raimes SM Griffin (1999) ArticleTitlePeritoneal cytology in the surgical evaluation of gastric carcinoma Br J Cancer 79 520–4 Occurrence Handle10.1038/sj.bjc.6690081 Occurrence Handle10027323
E Bando Y Yonemura Y Takeshita K Taniguchi T Yasui Y Yoshimitsu et al. (1999) ArticleTitleIntraoperative lavage for cytological examination in 1297 patients with gastric carcinoma Am J Surg 178 256–62 Occurrence Handle10.1016/S0002-9610(99)00162-2 Occurrence Handle10527450
S Abe H Yoshimura H Tabata M Tachibana N Monden T Nakamura et al. (1995) ArticleTitleCurative resection of gastric cancer: limitation of peritoneal lavage cytology in predicting the outcome J Surg Oncol 59 226–9 Occurrence Handle7630168
M Benevolo M Mottolese M Cosimelli M Tedesco D Giannarelli S Vasselli et al. (1998) ArticleTitleDiagnostic and prognostic value of peritoneal immunocytology in gastric cancer J Clin Oncol 16 3406–11 Occurrence Handle9779720
H Juhl M Stritzel A Wroblewski D Henne-Bruns B Kremer W Schmiegel et al. (1994) ArticleTitleImmunocytological detection of micrometastatic cells: comparative evaluation of findings in the peritoneal cavity and the bone marrow of gastric, colorectal, and pancreatic cancer patients Int J Cancer 57 330–5 Occurrence Handle8168992
H Nakanishi Y Kodera Y Yamamura S Ito T Kato T Ezaki et al. (2000) ArticleTitleRapid quantitative detection of carcinoembryonic antigen-expressing free tumor cells in the peritoneal cavity of gastric-cancer patients with real-time RT-PCR on the LightCycler Int J Cancer 89 411–7 Occurrence Handle10.1002/1097-0215(20000920)89:5<411::AID-IJC3>3.0.CO;2-5 Occurrence Handle11008202
Y Kodera H Nakanishi S Ito Y Yamamura Y Kanemitsu Y Shimizu et al. (2002) ArticleTitleQuantitative detection of disseminated free cancer cells in peritoneal washes with real-time reverse transcriptase-polymerase chain reaction: a sensitive predictor of outcome for patients with gastric carcinoma Ann Surg 235 499–506 Occurrence Handle10.1097/00000658-200204000-00007 Occurrence Handle11923605
T Fujimura T Ohta H Kitagawa S Fushida DI Nishimura Y Yonemura et al. (1998) ArticleTitleTrypsinogen expression and early detection for peritoneal dissemination in gastric cancer J Surg Oncol 69 71–5 Occurrence Handle10.1002/(SICI)1096-9098(199810)69:2<71::AID-JSO5>3.0.CO;2-R Occurrence Handle9808508
Y Yonemura T Fujimura U Nimomiya BS Kim E Bandou T Sawa et al. (2001) ArticleTitlePrediction of peritoneal micrometastasis by peritoneal lavaged cytology and reverse transcriptase-polymerase chain reaction for matrix metalloproteinase-7 mRNA Clin Cancer Res 7 1647–53 Occurrence Handle11410502
R Moll R Zimbelmann MD Goldschmidt M Keith J Laufer M Kasper et al. (1993) ArticleTitleThe human gene encoding cytokeratin 20 and its expression during fetal development and in gastrointestinal carcinomas Differentiation 53 75–93 Occurrence Handle8359595
SA Burchill MF Bradbury L Pittman J Southgate B Smith P Selby (1995) ArticleTitleDetection of epithelial cancer cells in peripheral blood by reverse transcriptase-polymerase chain reaction Br J Cancer 71 278–81 Occurrence Handle7530983
K Kubota H Nakanishi N Hiki N Shimizu E Tsuji H Yamaguchi et al. (2003) ArticleTitleQuantitative detection of micrometastases in the lymph nodes of gastric cancer patients with real-time RT-PCR: a comparative study with immunohistochemistry Int J Cancer 105 136–43 Occurrence Handle10.1002/ijc.11031 Occurrence Handle12672044
K Mori K Aoyagi T Ueda I Danjoh Y Tsubosa K Yanagihara et al. (2004) ArticleTitleHighly specific marker genes for detecting minimal gastric cancer cells in cytology negative peritoneal washings Biochem Biophys Res Commun 313 931–7 Occurrence Handle10.1016/j.bbrc.2003.12.025 Occurrence Handle14706632
LH Sobin C Wittekind (1997) TNM classification of malignant tumors EditionNumber5th ed. John Wiley & Sons New York
JS Macdonald SR Smalley J Benedetti SA Hundahl NC Estes GN Stemmermann et al. (2001) ArticleTitleChemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction N Engl J Med 345 725–30 Occurrence Handle10.1056/NEJMoa010187 Occurrence Handle11547741
Y Kodera K Isobe M Yamauchi T Satta T Hasegawa S Oikawa et al. (1993) ArticleTitleExpression of carcinoembryonic antigen (CEA) and nonspecific crossreacting antigen (NCA) in gastrointestinal cancer; the correlation with degree of differentiation Br J Cancer 90 130–6
Y Sugita Y Fujiwara H Taniguchi T Mori T Ishii H Niwa et al. (2003) ArticleTitleQuantitative molecular diagnosis of peritoneal lavage fluid for prediction of peritoneal recurrence in gastric cancer Int J Oncol 23 1419–23 Occurrence Handle14532985
K Oyama M Terashima A Takagane C Maesawa (2004) ArticleTitlePrognostic significance of peritoneal minimal residual disease in gastric cancer detected by reverse transcription-polymerase chain reaction Br J Surg 19 435–43 Occurrence Handle10.1002/bjs.4455
R Jung K Petersen W Kruger M Wolf C Wagener A Zander et al. (1999) ArticleTitleDetection of micrometastasis by cytokeratin 20 RT-PCR is limited due to stable background transcription in granulocytes Br J Cancer 81 870–3 Occurrence Handle10.1038/sj.bjc.6690778 Occurrence Handle10555760
O Glehen F Mohamed FN Gilly (2004) ArticleTitlePeritoneal carcinomatosis from digestive tract cancer: new management by cytoreductive surgery and intraperitoneal chemohyperthermia Lancet Oncol 5 219–28 Occurrence Handle10.1016/S1470-2045(04)01425-1 Occurrence Handle15050953
T Mori Y Fujiwara Y Sugita T Azama T Ishii K Taniguchi et al. (2003) ArticleTitleApplication of molecular diagnosis for detection of peritoneal micrometastasis and evaluation of preoperative chemotherapy in advanced gastric carcinoma Ann Surg Oncol 11 14–20 Occurrence Handle10.1245/ASO.2004.02.016
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Kodera, Y., Nakanishi, H., Ito, S. et al. Prognostic significance of intraperitoneal cancer cells in gastric carcinoma: detection of cytokeratin 20 mRNA in peritoneal washes, in addition to detection of carcinoembryonic antigen. Gastric Cancer 8, 142–148 (2005). https://doi.org/10.1007/s10120-005-0318-7
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DOI: https://doi.org/10.1007/s10120-005-0318-7