Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer

doi:10.3748/wjg.v11.i46.7374

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Dec 14, 2005 (publication date) through Nov 27, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Dec 14, 2005; 11(46): 7374-7377
Published online Dec 14, 2005. doi: 10.3748/wjg.v11.i46.7374

Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer

Ji-Kun Li, Miao Zheng, Chuan-Wen Miao, Jian-Hai Zhang, Guang-Han Ding, Wen-Shen Wu

Ji-Kun Li, Miao Zheng, Chuan-Wen Miao, Jian-Hai Zhang, Guang-Han Ding, Department of General Surgery, First Affiliated People's Hospital of Shanghai Jiaotong University, Shanghai 200080, China

Wen-Shen Wu, Department of Pathology, First Affiliated First People's Hospital of Shanghai Jiaotong University, Shanghai 200080, China

Author contributions: All authors contributed equally to the work.

Correspondence to: Ji-Kun Li, PhD, Department of General Surgery, First Affiliated People's Hospital of Shanghai Jiaotong University, Shanghai 200080, China. jkli2000@citiz.net

Telephone: +86-21-63240090 Fax: +86-21-63240825

Received: November 2, 2005
Revised: December 23, 2005
Accepted: December 28, 2005
Published online: December 14, 2005

Abstract

AIM: To evaluate the role of peritoneal lavage cytology (PLC) and carcinoembryonic antigen (CEA) determination of peritoneal washes (pCEA) in predicting the peritoneal metastasis and prognosis after curative resection of gastric cancer.

METHODS: PLC and radioimmunoassay of CEA were performed in peritoneal washes from 64 patients with gastric cancer and 8 patients with benign diseases.

RESULTS: The positive rate of pCEA (40.6%) was significantly higher than that of PLC (23.4%) (P<0.05). The positive rates of PLC and pCEA correlated with the depth of tumor invasion and lymph node metastasis (P<0.05). pCEA was found to have a higher sensitivity and a lower false-positive rate in predicting peritoneal metastasis after curative resection of gastric cancer as compared to PLC. The 1-, 3-, and 5-year survival rates of patients with positive cytologic findings or positive pCEA results were significantly lower than those of patients with negative cytologic findings or negative pCEA results (P<0.05). Multivariate analysis indicated that pCEA was an independent prognostic factor for the survival of patients with gastric cancer.

CONCLUSION: Intraoperative pCEA is a more sensitive and reliable predictor of peritoneal metastasis as well as prognosis in patients with gastric cancer as compared to PLC method.

Keywords: Stomach neoplasm; CEA protein; Peritoneal metastasis; Prognosis