title: Application of molecular diagnosis for detection of peritoneal micrometastasis and evaluation of preoperative chemotherapy in advanced gastric carcinoma.
abstract: BACKGROUND
  In advanced gastric cancer, peritoneal recurrence is the main cause of death after curative surgical resection. The aim of this report was to describe a novel approach for quantitative genetic diagnosis using peritoneal lavage for the identification of patients at high risk for peritoneal recurrence and for evaluation of the clinical response to intraperitoneal chemotherapy in advanced gastric cancer.
  
  
  METHODS
  Nineteen patients with advanced gastric cancer who underwent staging laparoscopy and intraperitoneal chemotherapy before surgical resection or systemic chemotherapy between June 1999 and September 2001 were enrolled in this study. All peritoneal lavage specimens, collected at both staging laparoscopy and gastrectomy, were subjected to real-time quantitative genetic diagnosis.
  
  
  RESULTS
  The reverse transcriptase polymerase chain reaction (RT-PCR) values decreased in 8 cases, stabilized as negative in 5, and increased in 6 during therapy. Patients whose RT-PCR values diminished and were ultimately negative survived except for one, and all but one patient whose values increased during treatment died of recurrence.
  
  
  CONCLUSIONS
  Quantitative evaluation of genetic changes can provide accurate, useful information on the effects of preoperative intra-abdominal chemotherapy and overall prognosis for patients with advanced gastric cancer.
authors.affiliation: Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Mori
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Yurika
authors.initials: Y
authors.lastname: Sugita
authors.forename: Takashi
authors.initials: T
authors.lastname: Azama
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ishii
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Keiji
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Shuji
authors.initials: S
authors.lastname: Takiguchi
authors.forename: Takushi
authors.initials: T
authors.lastname: Yasuda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology*; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002945:Cisplatin / Q000627:therapeutic use; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D036502:Infusions, Intralesional; D010535:Laparoscopy; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008819:Mice, Nude; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local; D010534:Peritoneal Neoplasms / Q000556:secondary*; D010865:Pilot Projects; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D002272:Carcinoembryonic Antigen; D016685:Mitomycin; D002945:Cisplatin