Diagnostic value of negative enrichment and immune fluorescence in situ hybridization for intraperitoneal free cancer cells of gastric cancer.

Anqiang Wang,Tao Fu,Qian Wang,Xin Ji,Tingxu Han,Yali Bai,Ji Zhang,Zhaode Bu,Xiaojiang Wu,Yingjie Yang,Jiafu Ji,Ke Ji,Yanwen Xue,Zhongwu Li,Guobin Xu

doi:10.21147/j.issn.1000-9604.2019.06.10

Abstract

ObjectiveTo explore the intraperitoneal free cancer cell (IFCC) detection value of negative enrichment and immune fluorescence in situ hybridization (NEimFISH) on chromosomes (CEN) 8/17. MethodsTo verify the reliability of NEimFISH, 29 gastric cancer tumors, their adjacent tissues and greater omental tissues were tested. Our study then included 105 gastric cancer patients for IFCC. We defined patients as IFCC-positive if a signal was detected, regardless of the detailed cancer cell numbers. A comparison of clinicopathological features was conducted among IFCC groups. We also compared the diagnosis value and peritoneal recurrence predictive value among different detection methods. The comparison of IFCC number was also conducted among different groups.ResultsA cutoff of 2.5 positive cells could distinguish all benign tissue samples and 97% of malignant tissue samples in our study. Compared to intestinal gastric cancer, patients with diffuse gastric cancer tended to have more IFCCs (6 vs. 4, P=0.002). The IFCC counts were often higher in the lymphovascular invasion positive group than negative group (3 vs. 1, P=0.022). All IFCC samples that were considered positive using conventional cytology were also found to be positive using NEimFISH. When compared to conventional cytology and paraffin pathology, NEimFISH had a higher IFCC positive rate (68.9%) and higher one-year peritoneal recurrence predictive value with area under the curve (AUC) of 0.922. ConclusionsGastric cancer could be effectively diagnosed by NEimFISH. The IFCC number found using NEimFISH on CEN8/17 is closely associated with Lauren type and vascular invasion of cancer. NEimFISH is a reliable detection modality with a higher positive detection rate, higher one-year peritoneal recurrence predictive value and quantitative features for IFCC of gastric cancer.

Highlights

Gastric cancer is one of the most common gastrointestinal malignant cancers, with approximately 990,000 new patients and 738,000 patients succumbing to the disease [1]
The gastric cancer cells were confirmed according to the signals of different markers
We found that the positive rate is higher in NEimFISH groups than in conventional cytology groups

Summary

Introduction

Gastric cancer is one of the most common gastrointestinal malignant cancers, with approximately 990,000 new patients and 738,000 patients succumbing to the disease [1]. Recent advances in treating gastric cancer have improved the clinical outcomes, a substantial proportion of patients are initially diagnosed with unresectable locally advanced or metastatic disease, and more than one-third of these patients have peritoneal metastasis [4]. Patients with gastric cancer peritoneal metastasis tend to have a poor prognosis and an advanced oncological stage. The 7th Edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual describes the criteria for unresectable disease, which include distant metastasis or peritoneal seeding [5], and the latter includes positive peritoneal cytology indicating peritoneal metastasis. How to precisely detect the peritoneal cancer cells becomes a big challenge for doctors and scientists

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Conclusion