• stomach neoplasms
• peritoneal neoplasms
• hyperthermic intraperitoneal chemotherapy
• drug therapy, combination
• catheters
• neoplasias gástricas
• neoplasias peritoneais
• quimioterapia intraperitoneal hipertérmica
• quimioterapia combinada
• cateteres

• Adolescent
• Adult
• Aged
• Humans
• Middle Aged
• Young Adult
• Antineoplastic Combined Chemotherapy Protocols/administration & dosage
• Antineoplastic Combined Chemotherapy Protocols/adverse effects
• Clinical Trials, Phase II as Topic
• Paclitaxel/administration & dosage
• Paclitaxel/adverse effects
• Peritoneal Neoplasms/secondary
• Peritoneal Neoplasms/therapy
• Prospective Studies
• Stomach Neoplasms/pathology
• Stomach Neoplasms/therapy

• Intraperitoneal free cancer cells
• RT-PCR
• locoregional recurrence
• rectal cancer

Thrombospondin 1 (THBS1) is known to play a key role in tumor metastasis, and aberrant DNA methylation is one of the mechanisms regulating THBS1. The present study investigated whether methylated THBS1 in circulating cell‐free DNA from preoperative peritoneal lavage fluid (PPLF) and peripheral blood could be used as a potential biomarker for predicting peritoneal dissemination in gastric cancer (GC) patients.

The status of THBS1 methylation was detected by quantitative methylation‐specific PCR (MSP) in tumor tissues, paired PPLF, and serum from 92 GC patients. The correlation between methylated THBS1 levels and peritoneal dissemination of GC was studied, and its diagnostic value for predicting peritoneal dissemination was clarified by the receiver operating characteristic (ROC) curve.

Aberrant THBS1 methylation in tumor tissues was significantly higher than that in paracancerous normal tissues (p < 0.0001). No THBS1 methylation was found in 40 healthy controls, and partial methylation was detected in 3 of 48 patients with chronic non‐atrophic gastritis. The frequency of THBS1 methylation in pairing PPLF and serum from 92 GC patients was 52.2% (48/92) and 58.7% (54/92), respectively. The results of methylated THBS1 in pairing PPLF and serum were similar to those of tumor tissues. Aberrant THBS1 methylation in tumor tissues and pairing PPLF or serum was closely related to peritoneal dissemination, tumor progression, and poor prognosis (all p < 0.0001).

Circulating methylated THBS1 DNAs in PPLF/serum may predict peritoneal dissemination, a potential poor prognostic factor for GC patients.

• THBS1 gene
• gastric carcinoma
• methylation
• peritoneal dissemination
• prognosis

• Cancer-related gene
• Gastric cancer
• PCR
• Peritoneal recurrence

• Carcinoembryonic antigen
• Gastric cancer
• Laparoscopic gastrectomy
• Peritoneal lavage fluids
• Recurrence
• Transcription–reverse transcription concerted reaction

Gastric cancer (GC) is a leading cause of worldwide cancer-related death. Being a highly heterogeneous disease, the current treatment of GC has been suboptimal due to the lack of subtype-dependent therapies. Peritoneal dissemination (PD) is a common pattern of GC metastasis associated with poor prognosis. Therefore, it is urgently necessary to identify patients at high risk of PD. PD is found to be associated with Lauren diffuse type GC. Molecular profiling of GC, especially diffuse type GC, has been utilized to identify molecular alterations and has given rise to various molecular classifications, shedding light on the underlying mechanism of PD and enabling identification of patients at higher PD risk. In addition, a series of diagnositc and prognostic biomarkers of PD from serum, peritoneal lavages and primary GCs have been reported. This comprehensive review summarizes findings on the multi-omic characteristics of diffuse type GC, the clinical significance of updating molecular classifications of GC in association with PD risk and research advances in PD-associated biomarkers.

• biomarker
• diffuse type gastric cancer
• gastric cancer
• molecular classification
• peritoneal dissemination

• Biomarker
• Carcinoembryonic antigen
• Gastric cancer
• Peritoneal metastasis
• Synaptotagmin XIII

• Carcinoembryonic antigen
• Gastric cancer
• Keratin-20
• Micrometastasis

• Gastric cancer
• Micrometastasis
• Prognosis

• gastric carcinoma
• peritoneal washing
• peritoneal lavage
• cytology
• carcinoembryonic antigen
• rt-pcr

• Adenocarcinoma/mortality
• Adenocarcinoma/pathology
• Gastric Lavage
• Humans
• Lymphatic Metastasis
• Neoplasm Recurrence, Local
• Peritoneal Cavity/pathology
• Prognosis
• Reproducibility of Results
• Risk Assessment
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology

Patients with peritoneal dissemination of pancreatic adenocarcinoma do not benefit from surgical resection, but radiologic and cytologic detection of peritoneal cancer lack sensitivity. This trial sought to determine if an oncolytic virus may be used as a diagnostic agent to detect peritoneal cancer.

Peritoneal washings from patients with pancreatic adenocarcinoma were incubated with the enhanced green fluorescent protein (eGFP)-expressing oncolytic herpes simplex virus (HSV) NV1066. eGFP-positive or negative status was recorded for each specimen and compared to results obtained by conventional cytologic evaluation. These results were correlated with recurrence and survival for patients who underwent R0 resection.

Of 82 patients entered in this trial, 12 (15%) had positive cytology and 50 (61%) had virally-mediated eGFP positive cells in peritoneal washings. All cytology-positive patients were also eGFP positive. HSV-mediated fluorescence detection had sensitivities of 94% and 100% for detection of any and peritoneal metastatic disease; respectively. Median recurrence free and disease specific survival were 6.5 and 18.3 months for eGFP positive patients, versus 12.2 and 36.2 months for eGFP negative patients (P = 0.01 and 0.19); respectively.

A genetically modified HSV can be used as a highly sensitive diagnostic agent for detection of micro-metastatic disease in patients with pancreatic adenocarcinoma and may improve patient selection for surgery.

•

Oncolytic virus-mediated fluorescence is a sensitive assay for detection of cancer cells in peritoneal fluid.

Pancreatic cancer is an aggressive disease. Even with complete surgical removal of a pancreatic tumor, recurrence is common. Patients with microscopic spread of cancer cells into the abdomen, or peritoneum, do not benefit from surgery. Current methods of detection of this kind of spread are not very sensitive. This study utilized a virus that specifically infects cancer cells and expresses a green fluorescent protein within them to detect peritoneal disease. Viral fluorescence was more sensitive than standard methods for detecting peritoneal disease and may help to identify which patients with pancreas cancer will benefit from surgery.

• Diagnostic laparoscopy
• Herpes simplex virus
• Oncolytic viral therapy
• Pancreatic adenocarcinoma
• Peritoneal fluid cytology

Accurately distinguishing serosal invasion in patients with gastric cancer (GC) prior to surgery can be difficult. Molecular analysis of peritoneal fluid (MAPF) for free cancer cells with higher sensitivity than other methods; however, its prognostic value for GC remains controversial, precluding its application in clinical practice.

PubMed, EMBASE and other databases were systematically searched. Thirty-one studies were eligible for the meta-analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled for overall survival (OS), disease-free survival (DFS) and peritoneal recurrence-free survival (PRF).

The current meta-analysis focused on patients with GC and negative cytological diagnoses. The results showed that positive MAPF status (MAPF⁺) led to poorer prognoses for OS (HR 2.59, 95% CI 1.99–3.37), DFS (HR 4.92, 95% CI 3.28–7.37) and PRF (HR 2.81, 95% CI 2.12–3.72) compared with negative MAPF status (MAPF^-). Moreover, among the patients with GC who received curative treatment, the MAPF⁺ patients had poorer prognoses for OS (HR 3.27, 95% CI 2.49–4.29), DFS (HR 3.90, 95% CI 2.74–5.57) and PRF (HR 5.45, 95% CI 3.70–8.03). A meta-analysis of multivariate-adjusted HRs demonstrated that MAPF⁺ status was an independent prognostic factor for patients with GC who underwent curative treatment (OS: HR 2.19, 95% CI 1.47–3.28; PRF: HR 3.44, 95% CI 2.01–5.87). Using the identical target genes (CEA, CEA/CK20) as molecular markers, the patients with GC who were MAPF⁺ had significantly worse prognoses for OS (CEA: HR 3.03, 95% CI 2.29–4.01; CEA/CK20: HR 4.24, 95% CI 2.42–7.40), DFS (CEA: HR 3.99, 95% CI 2.24–7.12; CEA/CK20: HR 4.31, 95% CI 1.49–2.48) and PRF (CEA: HR 4.45, 95% CI 2.72–7.31; CEA/CK20: HR 6.46, 95% CI 3.62–11.55) than the patients who were MAPF^-.

The above results demonstrate that MAPF could be a prognostic indicator for patients with GC who have a negative cytological diagnosis and/or are receiving curative treatment. MAPF could provide clinicians with additional prognostic information that could aid in developing individualized treatment plans prior to surgery. The widely used target genes CEA, CEA/CK20 were confirmed to be valuable MAPF markers for predicting the prognosis of GC.

The most frequent cause of treatment failure following surgery for gastric cancer is peritoneal dissemination, mainly caused by the seeding of free cancer cells from the primary gastric cancer, which is the most common type of spread. Unfortunately, there is no standard modality of intraperitoneal free cancer cells detection to predict peritoneal metastasis until now. We reviewed English literature in PubMed was done using the MeSH terms for gastric cancer, peritoneal wash, and reverse transcriptase polymerase chain reaction. All the articles were reviewed and core information was tabulated for reference. After a comprehensive review of all articles, the data was evaluated by clinical implication and predictive value of each marker for peritoneal recurrence. There are still many limitations to overcome before the genetic diagnosis for free cancer cells detection can be considered as routine assay. To make it a reliable diagnostic tool for detecting free cancer cells, the process and method of genetic detection with peritoneal washes should be standardized, and the development of simple diagnostic devices and easily available kits are necessary. Herein, we reviewed the past, present and future perspectives of the peritoneal lavage for the detection of intraperitoneal free cancer cells in patients with gastric cancer.

• Gastric cancer
• Peritoneal metastasis
• Free cancer cells
• Reverse transcriptase polymerase chain reaction
• Genetic detection

• CEA
• Gastric cancer
• Peritoneal lavage fluid
• TRC

• MMP7
• colorectal carcinoma

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor/biosynthesis
• Biomarkers, Tumor/genetics
• Colorectal Neoplasms/genetics
• Colorectal Neoplasms/metabolism
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/surgery
• Female
• Humans
• Male
• Matrix Metalloproteinase 7/biosynthesis
• Matrix Metalloproteinase 7/genetics
• Middle Aged
• Neoplasm Recurrence, Local/genetics
• Neoplasm Recurrence, Local/metabolism
• Neoplasm Recurrence, Local/pathology
• Peritoneum/metabolism
• Postoperative Period
• Prognosis

• Adenocarcinoma/diagnosis
• Adenocarcinoma/mortality
• Adenocarcinoma/pathology
• Adult
• Aged
• Aged, 80 and over
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Female
• Gastrectomy
• Gastric Bypass
• Gastric Lavage/methods
• Humans
• Laparoscopy
• Male
• Middle Aged
• Multivariate Analysis
• Peritoneal Cavity/pathology
• Prognosis
• Retrospective Studies
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology
• Survival Rate
• Time Factors
• Treatment Outcome

• Bauhinia purpurea lectin
• Gastric cancer
• Glycan
• Lectin microarray
• Recurrence

Peritoneal implantation metastasis of gastric cancer is the major reason for cancer recurrence after radical operations. As a new chemotherapeutic agent, raltitrexed has been widely used in intravenous chemotherapy for many kinds of cancers. However, no study has reported the efficacy and safety of raltitrexed in intraperitoneal chemotherapy. This study aimed to explore the safety of intraperitoneal chemotherapy with raltitrexed during gastric cancer operation compared to normal saline (NS) rinsing of the abdominal cavity.

In this prospective study, 91 gastric cancer patients undergoing surgery and reconstruction were consecutively enrolled and randomly assigned into two groups. Raltitrexed in NS (500 ml) was injected into the abdominopelvic cavity for the patients in the RT group (n = 48), while for the patients in the group NS (n = 43), only NS (500 ml) was injected. The postoperative complications, gas passage time, and adverse effects, according to NCI-CTCAE v3.0, were compared between the two groups.

There were no significant differences in age, sex, cancer pathological type, clinical stage or operation method between the two groups (all P >0.05). No significant difference was observed in adverse effects and postoperative complications between the two groups (all P >0.05). No significant change was found in the levels of red blood cells, white blood cells, platelets, lactate dehydrogenase, blood urea nitrogen, and alanine aminotransferase before and after the operation for both groups (all P >0.05). All adverse events were mild or moderate by NCI-CTCAE v3.0 (National Cancer Institute common terminology criteria for adverse events) grade.

The findings of the present study demonstrate that intraperitoneal chemotherapy with raltitrexed after gastric cancer operation is safe and could be used for patients.

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.

• Gastric cancer
• Peritoneal lavage
• Cytology
• Molecular diagnostic techniques
• Reverse transcriptase polymerase chain reaction
• Carcinoembryonic antigen

• Biomarkers, Tumor/genetics
• Flow Cytometry
• Genetic Predisposition to Disease
• Genetic Testing
• Humans
• Immunoassay
• Molecular Diagnostic Techniques
• Neoplasm Invasiveness
• Peritoneal Neoplasms/chemistry
• Peritoneal Neoplasms/diagnosis
• Peritoneal Neoplasms/genetics
• Peritoneal Neoplasms/secondary
• Peritoneal Neoplasms/therapy
• Phenotype
• Precision Medicine
• Predictive Value of Tests
• Prognosis
• Stomach Neoplasms/chemistry
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/genetics
• Stomach Neoplasms/pathology

• epithelial-to-mesenchymal transition
• gastric cancer
• peritoneal washing
• zinc-finger E-box binding homeobox 1

• Aged
• Carcinoembryonic Antigen/biosynthesis
• Female
• Follow-Up Studies
• Humans
• Male
• Melanoma-Specific Antigens/biosynthesis
• Middle Aged
• Peritoneal Lavage
• Peritoneal Neoplasms/diagnosis
• Peritoneal Neoplasms/secondary
• Prognosis
• Stomach Neoplasms/pathology

• RT-PCR
• gastric cancer
• micrometastasis
• molecular biology
• peritoneal dissemination

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents/therapeutic use
• Ascitic Fluid/metabolism
• Carcinoembryonic Antigen/metabolism
• Chemotherapy, Adjuvant
• Female
• Follow-Up Studies
• Gastrectomy
• Gastric Bypass
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Invasiveness
• Neoplasm Micrometastasis/diagnosis
• Peritoneal Lavage
• Peritoneal Neoplasms/diagnosis
• Peritoneal Neoplasms/secondary
• Prognosis
• Prospective Studies
• Reverse Transcriptase Polymerase Chain Reaction
• Serous Membrane/pathology
• Stomach Neoplasms/metabolism
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Survival Analysis

• EpCAM
• T cells
• adjuvant immunotherapy
• catumaxomab
• gastric cancer
• tumor immunology

• Complete block technique
• Gastric cancer on anterior wall of antrum
• Intraoperative metastases
• Radical gastrectomy

• Adenocarcinoma/genetics
• Adenocarcinoma/secondary
• Adenocarcinoma/surgery
• Adult
• Aged
• Aged, 80 and over
• Female
• Follow-Up Studies
• Humans
• Immunoenzyme Techniques
• Laparotomy
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Recurrence, Local/metabolism
• Neoplasm Recurrence, Local/pathology
• Neoplasm Recurrence, Local/surgery
• Neoplasm Staging
• Peritoneal Lavage
• Peritoneal Neoplasms/genetics
• Peritoneal Neoplasms/secondary
• Peritoneal Neoplasms/surgery
• Prognosis
• RNA, Messenger/genetics
• RNA-Binding Proteins/genetics
• RNA-Binding Proteins/metabolism
• Real-Time Polymerase Chain Reaction
• Reverse Transcriptase Polymerase Chain Reaction
• Stomach Neoplasms/genetics
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Survival Rate

AIM: To investigate whether gene methylation in the peritoneal fluid (PF) predicts peritoneal recurrence in gastric cancer patients.

METHODS: The gene methylation of CHFR (checkpoint with forkhead and ring finger domains), p16, RUNX3 (runt-related transcription factor 3), E-cadherin, hMLH1 (mutL homolog 1), ABCG2 (ATP-binding cassette, sub-family G, member 2) and BNIP3 (BCL2/adenovirus E1B 19 kDa interacting protein 3) were analyzed in 80 specimens of PF by quantitative methylation-specific polymerase chain reaction (PCR). Eighty patients were divided into 3 groups; Group A (n = 35): the depth of cancer invasion was less than the muscularis propria; Group B (n = 31): the depth of cancer invasion was beyond the muscularis propria. Both group A and B were diagnosed as no cancer cells in peritoneal cytology and histology; Group C (n = 14): disseminated nodule was histologically diagnosed or cancer cells were cytologically defined in the peritoneal cavity.

RESULTS: The positive rates of methylation in CHFR, E-cadherin and BNIP3 were significantly different among the 3 groups and increased in order of group A, B and C (0%, 0% and 21% in CHFR, P < 0.05; 20%, 45% and 50% in E-cadherin, P < 0.05; 26%, 35% and 71% in BNIP3, P < 0.05). In addition, the multigene methylation rate among CHFR, E-cadherin and BNIP3 was correlated with group A, B and C (9%, 19% and 57%, P < 0.001). Moreover, the prognosis was analyzed in group B, excluding 3 patients who underwent a non-curative resection. Two of the 5 patients with multigene methylation showed peritoneal recurrence after surgery, while those without or with a single gene methylation did not experience recurrence (P < 0.05).

CONCLUSION: This study suggested that gene methylation in the PF could detect occult neoplastic cells in the peritoneum and might be a risk factor for peritoneal metastasis.

• Ascites
• Dissemination
• Gastric cancer
• Methylation
• Peritoneal fluid
• Quantitative methylation-specific polymerase chain reaction

AIM: To analyze the incidence rate and relative factors of distant occult peritoneal metastasis (DOMP) of gastric carcinoma as well as their influences on prognosis.

METHODS: Fifty-eight patients with gastric carcinoma undergoing radical surgery in our hospital from January 2002 to December 2003 were selected, and distant metastasis was not found by preoperative imaging examination and routine intraoperative physical exploration. Before closing abdomen in operation, two slices of peritoneum from each side of Tau's cavity were cut for HE and cytokeratin immunohistochemical staining. The gender, age of patients, tumor location, size, invasion depth, differentiation degree, Laurén classification and lymph lode metastasis were compared between the DOPM and non-DOMP cases. Logistic multivariable regression analysis was used to distinguish whether the above variables are independent relative factors for DOMP.

RESULTS: Among the 58 cases, there were 12 cases with DOMP, accounting for 20.7%. Single factor analysis showed that DOMP is associated with the gender of patients, tumor size, invasion depth, Laurén classification (diffusing class) and lymph node metastasis, but had nothing to do with the age patients, tumor location and differentiation degree. Logistic multivariable regression analysis showed that the independent relative factors of DOMP were Laurén classification (diffusing class) and tumor size, but not the gender, age of patients, tumor location, invasion depth, differentiation degree and lymph node metastasis. Among 58 cases, the 5-year survival rate of patients was 100% in stageⅠ and Ⅱ, 94.1% in stage Ⅲ and 24.7% in stage Ⅳ (P < 0.001). The 5-year survival rate of DOMP patients was 30.3%, which was similar to that of the stage-N3 patients (22.1%), but significantly different from that of the stage-Ⅲ patients (P < 0.001).

CONCLUSION: DOMP occurs frequently in gastric carcinoma, so routine detection for DOMP should be applied to in patients with advanced gastric carcinoma and diffusing classification (Laurén classification).

• Gastric carcinoma
• Peritoneal metastasis
• Stage
• Classification
• Immunohistochemistry

• Adenocarcinoma/pathology
• Aged
• Aged, 80 and over
• Clinical Protocols
• Female
• Humans
• Male
• Middle Aged
• Pancreatic Neoplasms/pathology
• Peritoneum/pathology
• Pilot Projects
• Prospective Studies
• ROC Curve
• Reverse Transcriptase Polymerase Chain Reaction
• Sensitivity and Specificity

• Carcinoembryonic Antigen/genetics
• Colorectal Neoplasms/mortality
• Colorectal Neoplasms/pathology
• Female
• Humans
• Keratin-20/genetics
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local/etiology
• Neoplasm Recurrence, Local/pathology
• Peritoneal Neoplasms/etiology
• Peritoneal Neoplasms/pathology
• Prognosis
• RNA, Messenger/analysis
• Reverse Transcriptase Polymerase Chain Reaction/methods
• Stomach Neoplasms/mortality
• Stomach Neoplasms/pathology

• Abdominal Cavity
• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Carcinoembryonic Antigen/analysis
• Glyceraldehyde-3-Phosphate Dehydrogenases/analysis
• Humans
• Keratin-20/analysis
• Neoplasm Seeding
• Omentum/surgery
• Peritoneal Lavage
• Peritoneal Neoplasms/secondary
• Peritoneal Neoplasms/surgery
• Peritoneum/cytology
• Peritoneum/surgery
• Reverse Transcriptase Polymerase Chain Reaction
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery

• Adenocarcinoma/drug therapy
• Adenocarcinoma/secondary
• Animals
• Antimetabolites, Antineoplastic/therapeutic use
• Gastrointestinal Neoplasms/pathology
• Humans
• Peritoneal Neoplasms/drug therapy
• Peritoneal Neoplasms/secondary
• Pyrimidine Nucleosides/chemistry
• Pyrimidine Nucleosides/metabolism

• Aged
• Carcinoembryonic Antigen/analysis
• Carcinoembryonic Antigen/genetics
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Invasiveness
• Peritoneal Lavage
• Peritoneal Neoplasms/diagnosis
• Peritoneal Neoplasms/pathology
• Predictive Value of Tests
• Prognosis
• RNA, Messenger/analysis
• Reverse Transcriptase Polymerase Chain Reaction
• Stomach Neoplasms/pathology