Free Cancer Cell Detection in Peritoneal Cavitr of Gastric Cancer Patients by RT-PCR for CEA

Kim, See Young; Lee, Jong Inn; Moon, Nan Mo; Paik, Nam Sun; Choi, Dong Wook; Bang, Ho Yoon; Noh, Woo Chul

Abstract

PURPOSE: This study is aimed to evaluate the efficacy of a novel method (RT-PCR for CEA) to diagnose free cancer cells in peritoneal cavity of gastric cancer patients, which can be used as a indication of prophylactic treatment to prevent peritoneal recurrence after curative resection of gastric cancer.
MATERIALS AND METHODS
114 gastric adenocarcinoma patients were included for this study. With pellet of peritoneal washing fluid, cytology and RT-PCR for CEA were performed with specific primers.
RESULTS
Positive rate of PCR as a whole was 55.3% (63 cases); however, that of cytology was 15.8% (18 cases). Positive rate of PCR increased with depth of invasion of the lesion (p=0.026); however, that of cytology didn't (p=0.233). In early gastric cancer and seeding cases, PCR was not more sensitive than cytologic examination in detection of free cancer cell, but in pm, ss and si cancers, PCR was much more sensitive than cytology (p<0.001).
CONCLUSION
PCR was more sensitive to diagnose free cancer cells in peritoneal cavity of gastric cancer patients especially in pm, ss and si cancers than conventional cytologic examination, and it can be a good candidate of indication of prophylactic treatment to prevent peritoneal recurrence after curative resection.