Analyzing Gastric Lavage of Gastric Cancer Patients: A Prospective Observational Study on Cytopathology and Determination of Intragastric CEA, CA 19.9, CA 72.4, and CA 50.
OBJECTIVE
To investigate gastric lavage (GL) cytopathology and immunometric analysis as novel clinicopathologic and prognostic parameters for gastric cancer (GC).


METHODS
In 38 patients with gastric adenocarcinoma, we performed a cytopathologic analysis and an immunometric assay of GL using four tumor markers (CEA, CA 19.9, CA 72.4, and CA 50). The intragastric tumor marker levels were compared with a control group consisting of 41 non-GC patients to determine a statistically significant cutoff value.


RESULTS
GL cytopathology demonstrated the presence of cancer cells in 13 (34.2%) of the 38 GC patients: such a finding correlated to the parameters pT and pN with a statistically significant validity (p < 0.0267 and p < 0.0306, respectively). Measurement of intragastric CA 19.9 and CA 50 attained a statistically significant cutoff value (p < 0.002 and p < 0.0096, respectively), which was invalidated by the low sensitivity of the ROC curve analysis.


CONCLUSIONS
In contrast to determination of its tumor markers, GL cytopathology correlated well with pT and pN staging parameters. Should this and other features be corroborated by future studies, the GL cytology test could be routinely used to detect aggressive types of GC even at early stages and result in important progress in the knowledge, staging, prediction, as well as management and follow-up of this inauspicious type of cancer.
Division of Emergency Surgery, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University Sapienza, St. Andrea Hospital, Rome, Italy.
Edoardo
E
Virgilio
Enrico
E
Giarnieri
Monica
M
Montagnini
Rosaria
R
D''Urso
Antonella
A
Proietti
Alessandra
A
Mesiti
Maria Rosaria
MR
Giovagnoli
Paolo
P
Mercantini
Marco
M
Cavallini
Genoveffa
G
Balducci
D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism; D018395:CA-19-9 Antigen / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D005260:Female; D005751:Gastric Lavage / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; C082699:CA-50 antigen; C083825:CA-72-4 antigen; D002272:Carcinoembryonic Antigen