Published online Dec 21, 2014. doi: 10.3748/wjg.v20.i47.17796
Revised: June 7, 2014
Accepted: June 25, 2014
Published online: December 21, 2014
To apply an individualized oncological approach to gastric cancer patients, the accurate diagnosis of disease entities is required. Peritoneal metastasis is the most frequent mode of metastasis in gastric cancer, and the tumor-node-metastasis classification includes cytological detection of intraperitoneal cancer cells as part of the staging process, denoting metastatic disease. The accuracy of cytological diagnosis leaves room for improvement; therefore, highly sensitive molecular diagnostics, such as an enzyme immunoassay, reverse transcription polymerase chain reaction, and virus-guided imaging, have been developed to detect minute cancer cells in the peritoneal cavity. Molecular targeting therapy has also been spun off from basic research in the past decade. Although conventional cytology is still the mainstay, novel approaches could serve as practical complementary diagnostics to cytology in near future.
Core tip: For patients with gastric cancer, cytological detection of cancer cells in the peritoneal cavity is important to predict future manifestation of peritoneal recurrence. However, its improvement has been a matter of research, because of its low sensitivity and specificity. The new diagnostic modalities have been investigated along with the development of modern molecular biology. The recent innovative challenges regarding molecular diagnosis of intra-peritoneal gastric cancer cells have been thoroughly covered and summarized. The new therapies for gastric cancer with peritoneal spreads were also referred.