Detection of free malignant cells in the peritoneal cavity before and after resection of colorectal cancer.
OBJECTIVE
This study was designed to select the best monoclonal antibody to stain malignant cells in peritoneal wash fluid, and to investigate the incidence of free malignant cells in preresection and postresection colorectal cancer peritoneal washings using a combination of conventional cytology and immunocytochemistry.


METHODS
Peritoneal washings were taken from 35 consecutive patients undergoing colorectal cancer resection.


RESULTS
Malignant cells were isolated on a density gradient and identified by conventional cytology and an indirect immunoperoxidase stain. Malignant cells were identified in peritoneal washings from 15 patients (preresection only n = 3, postresection only n = 4, both n = 8). The origin of free malignant peritoneal cells in 11 preresection-positive washings must be the serosa. The origin of these cells in the four postresection-positive patients is uncertain: serosal and luminal spillage were considered unlikely and no circulating cells were found in the mesenteric vessels near the tumor.


CONCLUSIONS
Tumor cells may have leaked out from lymphatics cut during the dissection.
Leather
A J
AJ
Imperial Cancer Research Fund Colorectal Cancer Unit, St. Mark's Hospital, London, United Kingdom.
Kocjan
G
G
Savage
F
F
Hu
W
W
Yiu
C Y
CY
Boulos
P B
PB
Northover
J M
JM
Phillips
R K
RK
D000368:Aged; D000911:Antibodies, Monoclonal; D001202:Ascitic Fluid / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D010533:Peritoneal Lavage; D012704:Serous Membrane / Q000473:pathology; D014407:Tumor Cells, Cultured / Q000276:immunology
D000911:Antibodies, Monoclonal