Reference - Detail
|Author||Yoneda A, Taniguchi K, Torashima Y, Susumu S, Kanetaka K, Kuroki T, Eguchi S.|
|Title||The detection of gastric cancer cells in intraoperative peritoneal lavage using the reverse transcription--loop-mediated isothermal amplification method.|
|Journal||J. Surg. Res.|
INTRODUCTION:To detect a small number of malignant cells, we used a highly sensitive detection system that measures the expression levels of cytokeratin (CK) 19 messenger RNA by reverse transcription-loop-mediated isothermal amplification (RT-LAMP).
MATERIALS AND METHODS:We evaluated the clinical relevance of our novel diagnostic method with an RT-LAMP assay using CK19 as a target gene for the detection of free cancer cells in peritoneal lavage and assessed the clinical significance of the molecular diagnosis by survival analysis and frequency of recurrence, with a median follow-up period of 39 mo. We observed 52 patients with gastric cancer who underwent gastrectomy, bypass operation, and exploratory laparotomy.
RESULTS:Those 52 patients, who were subjected to both RT-LAMP and cytologic examination, were divided into the following three groups: (1) patients positive by cytology and RT-LAMP (CY+/LAMP+) (n = 9), (2) patients positive by LAMP and negative by cytology (CY-/LAMP+) (n = 12), and (3) patients negative by both cytology and LAMP (CY-/LAMP-) (n = 31). All patients with simultaneous peritoneal dissemination and positive cytology were positive on RT-LAMP. The results of RT-LAMP were statistically significant for recurrence by univariate analysis (P < 0.005). Cytology-positive cases had a very poor prognosis, and RT-LAMP-positive cases had a worse prognosis than RT-LAMP-negative cases.
CONCLUSIONS:Our findings suggest that CK19 RT-LAMP would be useful as an intraoperative diagnostic modality to detect patients with a high risk of recurrence even after clinically curative surgery, who thus require proper adjuvant therapy.
|MeSH||Adult Aged Biomarkers, Tumor / genetics Carcinoma / genetics Carcinoma / mortality Carcinoma / secondary* DNA, Neoplasm / analysis Female Humans Intraoperative Period Keratin-19 / genetics Male Middle Aged Molecular Diagnostic Techniques / methods Neoplastic Cells, Circulating / pathology* Peritoneal Lavage / methods* RNA, Messenger / analysis Reverse Transcriptase Polymerase Chain Reaction / methods* Sensitivity and Specificity Stomach Neoplasms / genetics Stomach Neoplasms / mortality Stomach Neoplasms / secondary*|
|Human and Animal Cells|