Rapid Genetic Diagnosis With the Transcription?Reverse Transcription Concerted Reaction System for Cancer Micrometastasis

Ishii, Takaaki; Fujiwara, Yoshiyuki; Ohnaka, Satoru; Hayashi, Toshinori; Taniguchi, Hirokazu; Takiguchi, Shuji; Yasuda, Takushi; Yano, Masahiko; Monden, Morito

doi:10.1245/aso.2004.12.043

Cited by 42 publications

(51 citation statements)

References 21 publications

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“…We applied the method with CEA as a marker for the detection of free cancer cells in peritoneal washes. The sensitivity and quantifi cation of the TRC reaction for the detection of occult cancer cells in peritoneal washes were comparable to those of the conventional quantitative RT-PCR with the LightCycler [37]. It is anticipated that these post-PCR diagnostic systems will contribute to the clinical application of genetic diagnosis in the near future.…”

Section: Novel Molecular Techniques For Detection Of Micrometastasismentioning

confidence: 85%

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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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Section: Novel Molecular Techniques For Detection Of Micrometastasismentioning

confidence: 85%

“…The TRC method is superior to the RT-PCR method in rapidity and simplicity (Fig. 3) [37]. We applied the method with CEA as a marker for the detection of free cancer cells in peritoneal washes.…”

Section: Novel Molecular Techniques For Detection Of Micrometastasismentioning

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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“…Current experimental studies which aim to identify a rapid, accurate, and cost-effective detection method are ongoing. The transcription-reverse transcription concerted reaction (TRC) system, as described by Ishii et al [27] and Ohashi et al [51], and the LightCycler system described by Kodera et al [52] have shown promise in IFCC detection by providing results in as little as 1-2 h. Cost, however, still remains a considerable limitation.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

et al. 2011

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Background There is lack of uniformity in the utilization of peritoneal cytology in gastric cancer management. The identification of intraperitoneal free cancer cells (IFCCs) is believed to confer poor prognosis. However, while some of these patients are palliated, others may undergo more aggressive therapies. In this review, we aimed to identify and synthesize findings on the use of peritoneal cytology in predicting peritoneal recurrence and overall survival in curative gastric cancer patients. Methods Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 31, 2009. We determined the accuracy, sensitivity, and specificity of peritoneal cytology in predicting peritoneal recurrence based on four techniques-conventional cytology, immunoassay, immunohistochemistry, and reverse transcriptase-polymerase chain reaction. Recurrence rates and overall survival rates for curative patients were determined, based on positivity or negativity for IFCCs. Results Twenty-eight articles were included. All four techniques showed wide variations in accuracy, sensitivity, and specificity in predicting peritoneal recurrence. Recurrence rates for patients positive for IFCCs ranged from 11.1 to 100%, while those negative for IFCCs had recurrence rates of 0-51%. Overall survival was significantly reduced for patients with positive IFCCs. Short follow-up periods and possible duplication of results may limit result interpretation. Conclusion The presence of IFCCs appears to increase the risk of peritoneal recurrence and is associated with worse overall survival in gastric cancer patients. Further incorporation of peritoneal cytology in clinical decisionmaking in gastric cancer depends on the development of a consistently accurate and rapid IFCC detection method.

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“…Second, an additional complicating factor in the domain of preoperative staging is the advent of novel, more sensitive methods of detecting micrometastatic disease using immunohistochemical methods or RT-PCR [44], as alluded to earlier in this discussion. Papanicolaou staining remains the current 'gold standard' because of the various limitations in immunohistochemical and molecular methods including (but not limited to) the laborious processes required, the high costs involved, and the possibility of false-positive results with illegitimate transcription of noncancerous cells [45,46]. These factors, and the differences between protocols and procedures between the 'East' and 'West,' prevent any possible adoption of these new techniques addressed by this study to any population.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of gastric cancer treatment in patients with positive peritoneal cytology

et al. 2014

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Gastric cancer patients with positive peritoneal cytology as the only marker of metastatic disease have poor prognoses. There is no universal consensus on the most appropriate treatment regimen for this particular patient group. We reviewed and analyzed published data to determine the optimal treatment regimen for patients with peritoneal cytology-positive gastric adenocarcinomas. Six electronic databases were explored [PubMed, Cochrane (Systematic Reviews and Controlled Trials), PROSPERO, DARE, and EMBASE]. The primary outcome was overall survival with secondary outcomes including patterns of recurrence and treatment-related morbidity. Six studies were included for data extraction. There was no significant heterogeneity between studies. The use of S1 monotherapy was associated with a significant survival benefit (HR 0.48; 95 % CI 0.32-0.70; p = 0.0002). Intraoperative intraperitoneal chemotherapy (IIPC) with adjuvant chemotherapy showed a trend toward improvement in overall survival (HR 0.70; 95 % CI 0.47-1.04; p = 0.08). A recent randomized controlled trial examining extensive intraperitoneal lavage (EIPL) with IIPC showed a significant improvement in overall survival (5-year overall survival, 43.8 % for EIPL-IPC group compared with 4.6 % for IPC group). However, these promising results need to be validated in larger prospective randomized trials.

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Rapid Genetic Diagnosis With the Transcription?Reverse Transcription Concerted Reaction System for Cancer Micrometastasis

Cited by 42 publications

References 21 publications

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

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

A systematic review of the accuracy and utility of peritoneal cytology in patients with gastric cancer

A systematic review and meta-analysis of gastric cancer treatment in patients with positive peritoneal cytology

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