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


CONCLUSIONS
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.
Li
Ji-Kun
JK
Department of General Surgery, First Affiliated People's Hospital of Shanghai Jiaotong University, Shanghai 200080, China. jkli2000@citiz.net
Zheng
Miao
M
Miao
Chuan-Wen
CW
Zhang
Jian-Hai
JH
Ding
Guang-Han
GH
Wu
Wen-Shen
WS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000556:secondary*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000276:immunology / Q000601:surgery
D002272:Carcinoembryonic Antigen