Department of Gastroenterological Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
J Surg Oncol. 2014 Feb;109(2):75-80. doi: 10.1002/jso.23472. Epub 2013 Oct 24.
The purpose of this study is to define the clinical significance of the molecular analysis of peritoneal lavage fluid in patients with gastric cancer in a multicenter prospective trial.
Quantitative RT-PCR with CEA and CK-20 mRNA as target markers was introduced for peritoneal lavage diagnosis in 141 patients with clinically advanced gastric cancer from 9 different institutes. We then evaluated the prognostic factors in patients and also evaluated predictive markers for peritoneal recurrence in 124 patients without peritoneal metastasis at surgery
Out of the 141 cases, 140 patients were successfully analyzed by RT-PCR of peritoneal lavage fluids. According to multivariate analysis, the combined results of RT-PCR (CEA and CK-20) and CK-20 alone in addition to pathological N (pN)-stage were significantly correlated with overall survival. Multivariate analysis showed that the RT-PCR (CEA and CK-20) and CEA alone in addition to pathological T-stage, pN-stage, and histological grade were significantly correlated with peritoneal recurrence after surgery.
This is the first multicenter prospective study to show that RT-PCR analysis of peritoneal lavage fluid with the combination of CEA and CK-20 markers was useful for predicting overall survival and peritoneal recurrence in patients with clinically advanced gastric cancer.
本研究旨在通过多中心前瞻性试验，确定胃癌患者腹腔灌洗液分子分析的临床意义。
在来自 9 个不同机构的 141 例临床晚期胃癌患者中，引入以 CEA 和 CK-20 mRNA 为靶标的定量 RT-PCR 进行腹腔灌洗诊断。然后，我们评估了患者的预后因素，并在 124 例手术时无腹膜转移的患者中评估了腹膜复发的预测标志物。
在 141 例病例中，有 140 例成功进行了腹腔灌洗液的 RT-PCR 分析。根据多变量分析，RT-PCR（CEA 和 CK-20）与 CK-20 单独以及病理 N（pN）期的联合结果与总生存显著相关。多变量分析显示，RT-PCR（CEA 和 CK-20）和 CEA 单独以及病理 T 期、pN 期和组织学分级与术后腹膜复发显著相关。
这是第一项多中心前瞻性研究，表明用 CEA 和 CK-20 标志物组合进行腹腔灌洗液 RT-PCR 分析可用于预测临床晚期胃癌患者的总体生存率和腹膜复发。
