Department of General Surgery, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
J Surg Oncol. 2012 Jul 1;106(1):17-23. doi: 10.1002/jso.23052. Epub 2012 Jan 18.
Free peritoneal tumor cells (FPTC) derive from the detachment of primary cancer and may result in peritoneal carcinomatosis. Since peritoneal lavage cytology has low sensitivity in detecting FPTC, our aim was to estimate the clinical relevance of FPTC detected using an approach based on multiple molecular techniques.
Samples of peritoneal lavage were collected from 27 gastric and 48 colorectal cancer patients. FPTC recovery and detection from peritoneal washes was performed by cytological examination and immunomagnetic enrichment for epithelial cells followed by immunofluorescence analysis for epithelial marker EpCAM/CD326 and carcinoembryonic antigen (CEA). CEA and CK20 mRNA levels were quantified using a real-time qRT-PCR system.
For gastric carcinoma the FPTC positivity rate acquired by cytology, immunofluorescence and qRT-PCR was 14.8%, 14.8%, and 78% and for colorectal carcinoma was 0%, 17%, and 42%, respectively. qRT-PCR positivity was correlated with a poor cancer-specific survival and time-to-recurrence rates in both gastric and colorectal carcinoma.
Epithelial immunoenrichment and immunofluorescence analysis allows unequivocal identification of the FPTC. The real time qRT-PCR showed higher sensitivity for the detection of CEA and CK20 mRNA levels and confirmed its prognostic value in gastrointestinal cancers.
游离腹膜肿瘤细胞（FPTC）来源于原发性癌症的脱落，可能导致腹膜癌病。由于腹膜灌洗细胞学在检测 FPTC 方面的敏感性较低，我们的目的是评估基于多种分子技术的 FPTC 检测的临床相关性。
从 27 例胃癌和 48 例结直肠癌患者中采集腹膜灌洗样本。通过细胞学检查和针对上皮细胞的免疫磁珠富集，从腹膜灌洗液中回收和检测 FPTC，然后进行上皮标志物 EpCAM/CD326 和癌胚抗原（CEA）的免疫荧光分析。使用实时 qRT-PCR 系统定量 CEA 和 CK20 mRNA 水平。
对于胃癌，细胞学、免疫荧光和 qRT-PCR 检测到的 FPTC 阳性率分别为 14.8%、14.8%和 78%，而对于结直肠癌，分别为 0%、17%和 42%。qRT-PCR 阳性与胃癌和结直肠癌患者的癌症特异性生存和复发时间率差相关。
上皮免疫富集和免疫荧光分析可明确鉴定 FPTC。实时 qRT-PCR 显示出更高的 CEA 和 CK20 mRNA 水平检测灵敏度，并证实其在胃肠道癌症中的预后价值。
