Detection of minimal gastric cancer cells in peritoneal washings by focused microarray analysis with multiple markers: Clinical implications
Detection of minimal gastric cancer cells in peritoneal washings by focused microarray analysis with multiple markers: Clinical implications
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DOI：
10.1245/s10434-006-9321-4
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发表时间：
2007-05-01
影响因子：
3.7
通讯作者：
Sasaki, Hiroki
中科院分区：
文献类型：
--
作者：
Mori, Kazuhiko;Suzuki, Tomohiro;Sasaki, Hiroki
背景：腹膜细胞学检查是胃癌预后的重要因素。然而，腹膜细胞学需要很高的技能，这可能解释了其低患病率。基于逆转录-聚合酶链反应的多标记基因或免疫细胞化学检测被评估为收集与细胞学相同类型数据的替代方法。方法：对179例胃癌患者的腹膜冲洗进行10个标记基因的多重逆转录-聚合酶链反应，并将其杂交成定制的寡核苷酸阵列。该试验的结果要么被证实为预后因素，要么通过免疫细胞化学细胞学证实癌细胞的存在。结果：44例无病病例中只有1例（2.2%）被微阵列检测显示为阳性，而14例常规细胞学阳性病例中有13例（93%）被发现为阳性。该检测进一步检测出大约三分之一细胞学阴性的腹膜复发患者（20.35%中的7例）或非腹膜复发患者（22.27%中的6例）。微阵列检测结果与免疫细胞化学细胞学结果高度一致，证实了5种抗CK20、FABP1、MUC2、TFF1和MASPIN的抗体。微阵列检测阳性病例的临床结果很差，细胞学阳性病例也是如此。结论：我们的检测虽然耗时且需要特殊设备，但其特异性和灵敏度等于或优于我们研究所的细胞学检测。通过微阵列检测检测到的最小游离腹膜癌细胞可以为胃癌患者提供与大量癌细胞相同的临床信息。抗maspin抗体可能有助于胃癌腹膜细胞学检查。
Background: Peritoneal cytology is an important prognostic factor of gastric cancer. However, peritoneal cytology requires great skill, which may explain its low prevalence. A reverse transcriptase-polymerase chain reaction-based assay with multiple marker genes or immunocytochemistry was assessed as an alternative method of gathering the same kind of data as cytology.Methods: Peritoneal washings from 179 patients with gastric cancer were analyzed by multiplex reverse transcriptase-polymerase chain reaction with 10 marker genes and subsequent hybridization to a customized oligo-nucleotide array. Results with this assay were either validated as a prognostic factor or confirmed by demonstrating the presence of cancer cells by immunocytochemical cytology.Results: Only 1 (2.2%) of 44 disease-free cases was shown to be positive by the microarray assay, whereas 13 (93%) of 14 conventional cytology-positive cases were found to be positive. This assay further detected approximately one-third of cytology-negative patients either with peritoneal recurrence (7 of 20, 35%) or with non-peritoneal recurrence (6 of 22, 27%). A high concordance between the microarray assay and immunocytochemical cytology with five antibodies against CK20, FABP1, MUC2, TFF1, and MASPIN was confirmed. The clinical outcome of the microarray assay-positive cases was poor, as was that of the cytology-positive cases.Conclusions: Our assay, though time-consuming and requiring special equipment, demonstrated a specificity and sensitivity equal to or better than cytology in our institutes. The minimal free peritoneal cancer cells detected by the microarray assay may provide the same clinical information as larger amounts of cancer cells for patients with gastric cancer. An anti-MASPIN antibody may be helpful in peritoneal cytology of gastric cancer.