Rapid detection of CEA mRNA in peritoneal washes using One-Step Nucleic acid Amplification (OSNA®) for gastric cancer patients

Gastric Cancer Cells in Peritoneal Lavage Fluid: A Systematic Review Comparing Cytological with Molecular Detection for Diagnosis of Peritoneal Metastases and Prediction of Peritoneal Recurrences

“…Conventional Papanicolaou staining was adopted in the vast majority of cases, followed by ordinary hematoxylin and eosin (H&E) coloration (9, 11) and Giemsa stain (17,28). Immunocytochemistry (ICC) was described only occasionally (10, 31,40,53). Sensitivity (12.3% to 67%) and specificity (94% to 100%) of PLC were clearly expressed as a percentage ratio only in 12 and 8 studies respectively (Table I).…”

“…PL was collected by introducing, stirring and aspirating from the abdominal cavity an aliquot of saline solution ranging from 50 ml (9, 27) to 200 ml (24,41). All the patients did not receive any neoadjuvant treatment and PLs were performed at the beginning of laparotomic gastrectomy (most works), laparoscopy surgery (conducted with curative or staging purpose) (35)(36)(37)(38)(39)(40)43), or paracentesis (only one case, 48). Conventional Papanicolaou staining was adopted in the vast majority of cases, followed by ordinary hematoxylin and eosin (H&E) coloration (9, 11) and Giemsa stain (17,28).…”

“…Such a disappointing constraint has been in part referred to the technical personal skills of the cytologist but, mostly, it has been reported that the manipulation of the tumor as well as surgical maneuvers (especially when the surgeons open the gastric wall or the lymphovascular vessels) can cause tumor spillage from gastric lumen to peritoneal cavity ensuing PM-PR (2, 58-64); in this sense, of interest, gastric lavage as well as PL might be helpful preventive methods to minimize the risk of spillage of GC cells and PR (2). To increase the sensitivity and reliability of cancer cell detection in PL, in the last two decades researchers employed ICC and molecular biological methods to detect epithelial cell-related targets (40). Compared to standard cytology, ICC with antibodies has been described improving the detection rate by 5% to 15%; nevertheless, (Table I).…”

“…Concerning specificity, on the other hand, both methods have often achieved 100% (4, 34) and PLC not infrequently was superior (14,25,39,48). Currently however, yet promising, the detection molecular methods are not applied for routine use everywhere: sometimes, in fact, they provided controversial results (such as false-positive cases with mRNAs released by lymphocytes and sane mesothelial cells and other false-positives results due to isolated tumor cells -that is clinically insignificant cells without metastatic potential-and not to micrometastases -the utter active metastatic cells-) and, most of all, they are time-consuming, labor-intensive and expensive (1, 32,24,40). With this respect, testing novel ultra-rapid molecular methods (such as OSNA, TCR and LAMP) (33,34,40,43,54) with innovative targets isolated not only from PLs but also from blood or tissue specimens of AGC patients (65,66) could surmount some temporal and costly limitations of the current genetic techniques.…”

Management of peritoneal metastasis of gastric cancer

“…A new rapid gene detection system, One-step nucleic acid amplification has been recently suggested. 41 Its simplicity and rapidity potentiates its routine use in the clinical laboratory. It also provides valuable clinical information for choosing the appropriate treatment for negative cytology patients: such patients are potential candidate to intraperitoneal therapy, such as HIPEC, immunotherapy or both…”