Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080, Lublin, Poland.
Department of Human Physiology, Medical University of Lublin, Radziwiłłowska 11 St., 20-080, Lublin, Poland.
Sci Rep. 2022 Jul 21;12(1):12477. doi: 10.1038/s41598-022-16761-8.
Peritoneal dissemination is a common form of gastric cancer (GC) recurrence, despite surgery with curative intent. This study aimed to evaluate the prognostic value of intraperitoneal lavage One-Step Nucleic Acid Amplification (OSNA) assay in advanced GC patients. OSNA assay targeting CK-19 mRNA was applied to detect free cancer cells (FCC) in intraperitoneal lavage samples obtained during gastrectomy. A total of 82 GC patients were enrolled to investigate the correlation between OSNA assay and patient's prognosis. Of the 82 patients, OSNA assay was positive in 25 (30.5%) patients. The median OS in OSNA positive patients was significantly lower than in OSNA negative patients (19 vs 45 months). Positive OSNA assay result was a significant unfavourable prognostic factor in both, univariable (HR 3.45, 95% CI 0.95-12.48; p = 0.0030) and multivariable analysis (HR 3.10, 95% CI 1.22-8.54; p = 0.0298). Positive OSNA assay in intraperitoneal lavage is a valuable indicator of poor survival in advanced GC patients after multimodal treatment. After further confirmation on larger sample size, OSNA assay of peritoneal washings could be considered an adjunct tool to conventional cytology, the current gold standard, to provide precise intraoperative staging and additional prognostic information.
尽管进行了有治愈意图的手术，但腹膜播散仍是胃癌（GC）复发的常见形式。本研究旨在评估腹腔灌洗一步法核酸扩增（OSNA）检测在晚期 GC 患者中的预后价值。该检测针对 CK-19 mRNA，用于检测胃切除术中获得的腹腔灌洗样本中的游离癌细胞（FCC）。共纳入 82 例 GC 患者，以研究 OSNA 检测与患者预后之间的相关性。在 82 例患者中，有 25 例（30.5%）OSNA 检测阳性。OSNA 阳性患者的中位 OS 明显低于 OSNA 阴性患者（19 个月 vs 45 个月）。OSNA 检测阳性结果是单变量分析（HR 3.45，95%CI 0.95-12.48；p=0.0030）和多变量分析（HR 3.10，95%CI 1.22-8.54；p=0.0298）中均为显著的不利预后因素。多模态治疗后，腹腔灌洗液中 OSNA 检测阳性是晚期 GC 患者生存不良的有价值指标。在更大的样本量上进一步确认后，腹腔冲洗液 OSNA 检测可以作为传统细胞学（目前的金标准）的辅助工具，提供精确的术中分期和额外的预后信息。
