Detection of peritoneal micrometastasis by reverse transcriptase-polymerase chain reaction for heparanase mRNA and cytology in peritoneal wash samples.
BACKGROUND
Peritoneal dissemination is the most common pattern of metastasis in advanced gastric carcinoma with serosal invasion. In the present study, we have reported the clinical relevance of a new diagnostic method with reverse transcriptase-polymerase chain reaction (RT-PCR) assay using heparanase as a target gene for detection of free cancer cells in peritoneal washes.


METHODS
Intraoperative peritoneal washes were obtained from 48 patients who underwent surgery for gastric cancer. RT-PCR analysis with primers specific for heparanase and conventional cytological examination were performed subsequently.


RESULTS
Heparanase RT-PCR was capable of detecting at least 10 tumor cells in 10 ml peritoneal wash fluid. There was no detectable heparanase expression in normal gastric epithelial cells and peritoneal wash samples from patients with benign disease. Twenty-five (52%) patients with gastric cancer had a detectable heparanase expression. Its positive rate was 100% and 59% for the cases with clinically evident peritoneal metastasis and serosal invasion, respectively, both of which are higher than that of cytology.


CONCLUSIONS
Heparanase mRNA detected in peritoneal lavaged fluid might indicate the presence of free cancer cells in peritoneal cavity. The high sensitivity of RT-PCR based heparanase assay made it a candidate molecular marker for detecting peritoneal micrometastasis.
Wang
Zhenning
Z
Department of Surgical Oncology, First Hospital of China Medical University, Shenyang, China.
Zhang
Xue
X
Xu
Huimian
H
Zhou
Xin
X
Jiang
Li
L
Lu
Chong
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005966:Glucuronidase / Q000032:analysis / Q000096:biosynthesis / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010529:Peritoneal Cavity / Q000166:cytology; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000201:enzymology / Q000556:secondary; D012333:RNA, Messenger / Q000096:biosynthesis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000201:enzymology / Q000473:pathology; D000099175:Heparanase
D005966:Glucuronidase; D012333:RNA, Messenger; D000099175:Heparanase