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Seriate cytology vs molecular analysis of peritoneal washing to improve gastric cancer cells detection

C. Taffon, I. Giovannoni, P. Mozetic, GT. Capolupo, V. La Vaccara, C. Cinque, C. Caricato, A. Rainer, G. Zelano, A. Crescenzi,

. 2019 ; 47 (7) : 670-674. [pub] 20190301

Jazyk angličtina Země Spojené státy americké

Typ dokumentu srovnávací studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc19044962

BACKGROUND: Intraperitoneal malignant cells detection in patients with gastric cancer is associated with a significant decrease in overall survival. The overall accuracy of cytological examination of peritoneal lavages, however, is quite low, and intraperitoneal recurrence has been observed even in patients with negative cytology. Immunocytochemistry and molecular techniques have been investigated to improve high-risk patients' identification with variable results. The aim of this study was to compare the performance of different laboratory methods applied to peritoneal washing, to improve the cytological identification of malignant cells. METHODS: We prospectively evaluated 21 patients who underwent surgery and peritoneal lavage for gastric cancer. Among them, 18 had negative cytology and three were positive for malignant cells. For each patient, immunohistochemistry with BerEP4 antibody was performed on seriate sections of cellblock preparation at different levels, using the method reported for sentinel nodes in other types of cancer. Paired frozen quotes of washing fluids were evaluated by qRT-PCR with primer for mRNA of Ceacam5. RESULTS: In 4 of 18 patients with previous negative routine cytology, isolated neoplastic cells in seriate sections of the cellblock inclusion have been found. Results showed to be coherent with molecular analysis for CEA mRNA. CONCLUSION: The sensitivity and specificity of peritoneal washing analyses should be notably improved by immunohistochemistry applied to multilevel cellblock sectioning. The method is less expensive and more widely applicable than molecular analysis, in each laboratory setting. This approach allows detection of minimum peritoneal seeding in patients with gastric cancer.

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$a BACKGROUND: Intraperitoneal malignant cells detection in patients with gastric cancer is associated with a significant decrease in overall survival. The overall accuracy of cytological examination of peritoneal lavages, however, is quite low, and intraperitoneal recurrence has been observed even in patients with negative cytology. Immunocytochemistry and molecular techniques have been investigated to improve high-risk patients' identification with variable results. The aim of this study was to compare the performance of different laboratory methods applied to peritoneal washing, to improve the cytological identification of malignant cells. METHODS: We prospectively evaluated 21 patients who underwent surgery and peritoneal lavage for gastric cancer. Among them, 18 had negative cytology and three were positive for malignant cells. For each patient, immunohistochemistry with BerEP4 antibody was performed on seriate sections of cellblock preparation at different levels, using the method reported for sentinel nodes in other types of cancer. Paired frozen quotes of washing fluids were evaluated by qRT-PCR with primer for mRNA of Ceacam5. RESULTS: In 4 of 18 patients with previous negative routine cytology, isolated neoplastic cells in seriate sections of the cellblock inclusion have been found. Results showed to be coherent with molecular analysis for CEA mRNA. CONCLUSION: The sensitivity and specificity of peritoneal washing analyses should be notably improved by immunohistochemistry applied to multilevel cellblock sectioning. The method is less expensive and more widely applicable than molecular analysis, in each laboratory setting. This approach allows detection of minimum peritoneal seeding in patients with gastric cancer.
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$a Giovannoni, Isabella $u Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy.
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$a Mozetic, Pamela $u International Clinical Research Center, St. Anne's University Hospital, Brno, Czechia.
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$a Capolupo, Gabriella Teresa $u Surgery Unit, University Hospital Campus Bio-Medico, Rome, Italy.
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$a La Vaccara, Vincenzo $u Surgery Unit, University Hospital Campus Bio-Medico, Rome, Italy.
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$a Cinque, Cristina $u Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy.
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$a Caricato, Chiara $u School of Medicine, Catholic University of the Sacred Heart, Rome, Italy.
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$a Rainer, Alberto $u Tissue Engineering Unit, Università Campus Bio-Medico di Roma, Rome, Italy.
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$a Zelano, Giovanni $u Institute of Human Anatomy and Cell Biology, Catholic University of the Sacred Heart, Rome, Italy.
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$a Crescenzi, Anna $u Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy.
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