Early Gastric Cancer Exfoliating into Gastric Lavage (GL1 EGC) Shows a More Aggressive Behavior and Poorer Survival Compared to the Non-Exfoliative Counterpart (GL0 EGC)

doi:10.21873/anticanres.11810

Cited by 2 publications

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“…In the last decade, cytologic and molecular investigation of GL has provided interesting findings in terms of diagnosis, screening, prognosis, and treatment of GC patients. [ 7 8 9 10 11 12 13 14 15 16 17 28 29 30 ] Concerning the cytologic aspect, as suggested by numerous authors, the oncologic value of GL derives from its privilege of collecting GC products released directly by the tumor avoiding hepatic clearance, a condition known under the name of Metastasis VI. [ 8 9 31 ] In the presence of a patent gastrointestinal tube, the exfoliation of malignant cells into the gastric lumen (Metastasis VI) strongly suggests the possibility that other cell elements have already migrated or infiltrated the surrounding tissue following the classical routes of metastasis (invasion through vascular or lymphatic channels, lymph nodes, direct contact, intraperitoneal or mesogastric seeding).…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 6 ] Since the last decade, cytologic and molecular analysis of gastric lavage (GL) of GC patients has provided interesting results. [ 7 8 9 10 11 12 13 14 15 16 17 ] Gastric bacterial microbiota (MB) represents another original issue for GC research drawing medical attention. [ 18 19 20 21 22 ] The stomach lumen, in fact, is not sterile and physiologically hosts a rich MB (approximately 10 2 –10 4 colony forming units per gram content) mainly composed of the genus Lactobacillus, Clostridium, Propionibacterium, Streptococcus , and Staphylococcus .…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Role of Intragastric Cytopathology and Microbiota in Surgical Patients with Stomach Cancer

Virgilio

Giarnieri²,

Carico³

et al. 2021

J Cytol

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Background: In the last decade, analysis of malignant cells and flora in gastric lavage (GL) has provided interesting data on pathogenesis of gastric cancer (GC). For this study, combining such two aspects into one cyto-microbiologic category, we tested the prognostic role of the presence/absence of cancer cells (GL1/GL0) and bacterial microbiota (MB1/MB0) in our GC population. Material and Methods: Between April 2012 and August 2019, 79 surgical patients with GC were prospectively investigated with the determination of GL MB. Results: Compared with GL1 MB0, GL1 MB1 strongly correlated with advanced GC, portended poorer overall survival (OS) (45.8 months vs 20.5 months, P = 0.049), and resulted a significant ( P = 0.008) and an independent ( P = 0.013) prognostic factor unfavorable for OS. Conclusion: In the light of our results, the cyto-microbiologic parameter of GL MB should be used to gain a better prognosis of GC patients. Administration of antimicrobial treatment for MB1 subjects should be entertained because it could reduce the risk of oncogenesis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Role of Intragastric Cytopathology and Microbiota in Surgical Patients with Stomach Cancer

Virgilio

Giarnieri²,

Carico³

et al. 2021

J Cytol

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Combined Analysis of Intragastric Malignant Exfoliation and Ca 72.4 Concentration in Stomach Adenocarcinoma: The “GL1 Ca 72.4” Parameter

et al. 2020

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Introduction/Objective: Differently from other digestive malignancies, gastric cancer (GC) pathobiology is still little known and understood. Recently, cytopathology and molecular biology on gastric juice/gastric lavage (GJ/GL) of GC patients have provided novel and interesting results in terms of screening, diagnosis, prognosis, and therapy. However, entertaining cytologic examination and molecular test as a unified solo-run test is previously unreported. Our aim was to assess the new parameter “GL Ca 72.4” for GC patients. Methods: Between April 2012 and July 2013, GJ/GL obtained from 37 surgical GC patients were tested for the presence/absence (GL1/GL0) of exfoliated malignant cells along with the intragastric concentration of Ca 72.4 (normal value <6.49 ng/mL: Ca 72.4n; elevated level ≥6.49 ng/mL: Ca 72.4+). Results: At a median follow-up of 79.3 months, all the GC alive patients were “GL0 Ca 72.4n.” The “GL1 Ca 72.4+” parameter, in comparison with GL0 Ca 72.4n, strongly correlated with deeper tumor invasion (p = 0.027), severe nodal metastasis (p = 0.012), worst metastatic node ratio (p = 0.041), higher number of metastatic lymph nodes (30 vs. 20 nodes, p = 0.014), angiolymphatic invasion (p = 0.044), advanced stage (p = 0.034), and adjuvant therapy (p = 0.044). The Kaplan-Meier model showed that GL1 Ca 72.4+ subjects had shorter overall survival (OS) than GL0 Ca 72.4n cases (9.7 vs. 43.2 months, respectively, p = 0.042). At univariate analysis, the GL1 Ca 72.4+ parameter resulted a significant prognostic factor for OS (p = 0.023). Conclusions: The combined cyto-molecular parameter “GL1 Ca 72.4+” appears to be a strong indicator of aggressive tumor behavior and a significant prognostic factor of poor survival for GC patients.

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Early Gastric Cancer Exfoliating into Gastric Lavage (GL1 EGC) Shows a More Aggressive Behavior and Poorer Survival Compared to the Non-Exfoliative Counterpart (GL0 EGC)

Abstract: In the case of EGC, the GL0-GL1 classification should become a routine clinical practice to identify the aggressive tumor phenotypes requiring for closer follow-up or additional treatment.

Cited by 2 publications

References 14 publications

Prognostic Role of Intragastric Cytopathology and Microbiota in Surgical Patients with Stomach Cancer

Prognostic Role of Intragastric Cytopathology and Microbiota in Surgical Patients with Stomach Cancer

Combined Analysis of Intragastric Malignant Exfoliation and Ca 72.4 Concentration in Stomach Adenocarcinoma: The “GL1 Ca 72.4” Parameter

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