Pathogenesis of peritoneal dissemination

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In order to clarify the mechanisms to explain of production of peritoneal dissemination, the following studies were perfomed.1. Post-operative peritoneal washing cytology in cases of endometrial carcinoma with positive peritoneal cytology. In order to assess the potential of malignant cells in the petitoneal cavity to metastasize, post-operative peritoneal cytology was undertaken. In 12 cases with endometrioid adenocarcinoma and intra-operative positive peritoneal cytology, a Silascon tube was indwelt in the abdominal cavity before closure of the abdomen. The peritoneal cavity was washed with saline 14 days after operation. The cytology of recovered washing was negative in all cases.2. Role of integrin on access of endometrial cancer cells into the pelvic cavity via the fallopian tube. I investigated the relationship between the expression of integrin and cases which had both superficial myometrial invasion and no lymph node metastasis and peritoneal positive cytologh. I showed that all four cases with histological grade 2 had the expression of beta3 integrin.3. Role of integrin on endometrial cancer metastasis to adnexa.I showed the significant relationshipm between the expression of beta1 integrin and adnexal metastasis (p<0.001).4. Risk of peritoneal dissemination in endmerial cancer or gastric cancer.I investigated the risk of peritoneal disseminataion in endometrial cancer and gastric cancer metastasis to ovary. I showed that the risk of peritoneal dissemination was lymph node metastasis rather than malignant cells in pelvic cavity.The above studies demonstrated that malignant cells in the peritoneal cavity appear to have a very low potential fora implantation into the peritoneum.