Prognostic significance of carcinoembryonic antigen levels in peritoneal washes in patients with gastric cancer

Abe, Nobutsugu; Watanabe, Takashi; Toda, Hiroshi; Machida, Hiromichi; Suzuki, Kazufumi; Terabe, Masaki; Mori, Toshiyuki; Sugiyama, Masanori; Nakaya, Yuzo

doi:10.1016/s0002-9610(01)00585-2

Cited by 25 publications

(21 citation statements)

References 18 publications

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“…Production of tumor markers by neoplasic cells present in the peritoneal cavity is considered the determining factor for levels in the peritoneal washing. Such levels depend on the number of cells present in the peritoneal cavity as well as their capacity to produce the marker (1,3,17,23,29,35) . Thus, raised serum levels of the tumor marker may be the result of increased production within the peritoneal cavity which, in turn, results in higher peritoneal and serum levels.…”

Section: Resultsmentioning

confidence: 99%

“…Thus, raised serum levels of the tumor marker may be the result of increased production within the peritoneal cavity which, in turn, results in higher peritoneal and serum levels. However, tumor marker produced by the primary neoplasia or its metastases can be captured by the systemic circulation, and discharged in the peritoneal cavity thereby increasing local levels of CA72-4 (1,3,17,29,35) . Therefore, the level of CA72-4 in the peritoneal washing may essentially reflect the presence of malignant cells within the peritoneal cavity.…”

Section: Resultsmentioning

confidence: 99%

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CA72-4 antigen levels in serum and peritoneal washing in gastric cancer: correlation with morphological aspects of neoplasia

Fernandes¹,

Martins²,

Nagashima

et al. 2007

Arq. Gastroenterol.

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-Background -Determining levels of tumor markers in peritoneal washing enables likelihood of peritoneal recurrence to be ascertained in patients with high marker levels, thereby allowing provision of more accurate adjuvant treatment and postoperative follow up. Aim -To analyze the relationship between levels of tumor marker CA72-4 in serum and peritoneal washing, and morphological aspects of gastric carcinoma. Method -This study analyzed 32 consecutively-operated patients with gastric carcinoma, who underwent subtotal, total or palliative gastrectomy. The variables studied were CA72-4 levels in serum and peritoneal washing, lesion site, stage, degree of cell differentiation, operation performed, and number of extirpated and involvement lymph nodes. Of the 32 patient sample, 21 (65.6%) were male and 11 (34.4%) female. Mean age was 62.6 ± 14.2 years (29 to 91 years). Following anesthetic induction, peripherical venous blood was collected through percutaneous punction of an upper limb vein. After the procedure, 50 mL of physiologic solution at 37ºC was introduced into the cul-de-sac. A 10 mL volume of this liquid was aspirated from the cavity and the peritoneal washing tested for CA72-4 levels. Normal values for CA72-4 levels in serum were considered ≤7 U/mL and high levels as >7U/mL, whilst for the peritoneal washing normal levels were ≤0.61 U/mL, and abnormal >0.61 U/mL. Results -Mean pre-operative serum levels for CA72-4 were 6.55 U/mL ± 15.30 (0.3 to 75.30 U/mL) whilst the mean level of CA72-4 in peritoneal washing was 8.50 U/mL ± 26.72 (0.3 to 142.00 U/mL); correlation between these levels was significant. Lymph nodes involvement by the gastric carcinoma correlated significantly with higher CA72-4 levels in both serum and peritoneal wash. There was no statistically significant correlation between serum level of CA72-4 and invasion into serosa by the gastric carcinoma. There was however, significant correlation between peritoneal washing levels of CA72-4 and involvement of serosa by gastric carcinoma. There was also a significant correlation between more advanced stages of gastric carcinoma and higher levels of CA72-4 in the peritoneal washing, although serum levels of CA72-4 and more advanced stage of gastric neoplasia showed no significant correlation. Degrees of cellular differentiation in the gastric carcinoma did not differ significantly with CA72-4 levels in serum or peritoneal washing. Conclusions -High levels of CA72-4 in peritoneal washing correlated significantly with lymph node metastasis and serosa involvement by the neoplasia, and also with more advanced stage of gastric carcinoma. The levels of CA72-4 in the blood correlated significantly with lymph node involvement by the gastric carcinoma, but not with serosa invasion or more advanced stage of neoplasia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

CA72-4 antigen levels in serum and peritoneal washing in gastric cancer: correlation with morphological aspects of neoplasia

Fernandes¹,

Martins²,

Nagashima

et al. 2007

Arq. Gastroenterol.

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“…Tumor markers, including the CEA level, were examined in peritoneal lavage fl uid and the associations with prognosis and peritoneal recurrence were assessed [32,33]. Yamamoto et al [34] evaluated the tumor markers CEA, carbohydrate antigen (CA) 125, and CA19-9 in peritoneal lavage fl uid, using a chemiluminescent enzyme immunoassay.…”

Section: Tumor Markers In Peritoneal Lavage Specimensmentioning

confidence: 99%

Genetic detection of free cancer cells in the peritoneal cavity of the patient with gastric cancer: present status and future perspectives

et al. 2007

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invasion within the gastric wall, in 752 patients with gastric cancer treated with curative resection at the Department of Gastroenterological Surgery, Osaka University Hospital. The peritoneum was the most frequent site of recurrence in patients with gastric cancer who received curative resection (34.3%). Furthermore, the frequency increased with increased depth of invasion of the gastric wall (subserosal invasion, 34.9%; serosal invasion, 46.7%; and invasion of adjacent organs, 60.0%).At present, cytological examination of peritoneal lavage fl uid collected at laparotomy is performed to predict peritoneal spread [3][4][5], and this procedure has been incorporated in the Japanese staging system for gastric cancer [6]. The majority of patients with positive cytology on peritoneal lavage develop peritoneal metastasis, although the latter also occurs in patients with negative cytological results [3][4][5]. These results indicate that the conventional cytological examination lacks sensitivity for the detection of residual cancer cells and prediction of peritoneal spread.Molecular diagnosis using reverse transcriptasepolymerase chain reaction (RT-PCR) analysis has been used recently for the detection of cancer micrometastases [7][8][9]. RT-PCR is more sensitive than conventional cytological examination [10][11][12]. Based on several studies, the results of RT-PCR of peritoneal lavage fl uid correlate strongly with peritoneal recurrence and prognosis after curative surgery in patients with advanced gastric cancer [10,[12][13][14][15][16][17].In this article, we review the present status and future perspectives of molecular analysis of peritoneal lavage in patients with gastric cancer. We also describe our preliminary results and their possible clinical application. AbstractThe purpose of this review is to examine the current status and future perspectives of the molecular analysis of peritoneal lavage fl uid in patients with gastric cancer. During the past 10 years, the polymerase chain reaction (PCR) has been applied for the molecular detection of free cancer cells in the ab dominal cavity of patients with gastric cancer, and its clinical signifi cance in establishing the presence of peritoneal dissemination has been assessed by several groups especially in Japan. The majority of these studies have confi rmed the predictive value of the molecular detection of peritoneal metastasis and recurrence using peritoneal lavage fl uid. Based on these fi ndings, since April 2006, the genetic diagnosis of body fl uids has been included in the Japanese Government public health insurance program for patients with solid tumors. However, there are still many obstacles to overcome before the genetic diagnosis of micrometastasis can be considered a routine laboratory assay. Here we review the importance of the molecular detection of cancer cells in the abdominal cavity, and the molecular techniques used for such diagnosis; we also provide some clinical examples to illustrate the value of molecular diagnosis.

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“…Recently, measurement of CEA level and CEA RT-PCR assay in peritoneal washes have been used to detect the existence of free cancer cells in the peritoneal cavity [10,22,23] . It was reported that RT-PCR based assay has a relatively high sensitivity but is time-consuming, relatively laborious and less practical [10,22] . In the present study, pCEA levels in peritoneal washes were measured in order to detect the presence of free cancer cells in 64 patients with gastric cancer.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer

Zheng²,

Chuanwen³

et al. 2005

WJG

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AIM:To evaluate the role of peritoneal lavage cytology (PLC) and carcinoembryonic antigen (CEA) determination of peritoneal washes (pCEA) in predicting the peritoneal metastasis and prognosis after curative resection of gastric cancer. METHODS:PLC and radioimmunoassay of CEA were performed in peritoneal washes from 64 patients with gastric cancer and 8 patients with benign diseases. RESULTS:The positive rate of pCEA (40.6%) was significantly higher than that of PLC (23.4%) (P <0.05). The positive rates of PLC and pCEA correlated with the depth of tumor invasion and lymph node metastasis (P <0.05). pCEA was found to have a higher sensitivity and a lower false-positive rate in predicting peritoneal metastasis after curative resection of gastric cancer as compared to PLC. The 1-, 3-, and 5-year survival rates of patients with positive cytologic findings or positive pCEA results were significantly lower than those of patients with negative cytologic findings or negative pCEA results (P <0.05). Multivariate analysis indicated that pCEA was an independent prognostic factor for the survival of patients with gastric cancer. CONCLUSION:Intraoperative pCEA is a more sensitive and reliable predictor of peritoneal metastasis as well as prognosis in patients with gastric cancer as compared to PLC method.

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Prognostic significance of carcinoembryonic antigen levels in peritoneal washes in patients with gastric cancer

Cited by 25 publications

References 18 publications

CA72-4 antigen levels in serum and peritoneal washing in gastric cancer: correlation with morphological aspects of neoplasia

CA72-4 antigen levels in serum and peritoneal washing in gastric cancer: correlation with morphological aspects of neoplasia

Genetic detection of free cancer cells in the peritoneal cavity of the patient with gastric cancer: present status and future perspectives

Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer

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