Significance of diagnostic laparoscopy and determination of free cancer cells in peritoneal lavage fluid in patients with gastric carcinoma

Abstract Peritoneal dissemination (PD) is the major type of gastric cancer (GC) recurrence and leads to rapid death. Current approach cannot precisely determine which patients are at high risk of PD. In this study, we developed a technology to detect minimal residual cancer cells in peritoneal lavage fluid (PLF) samples by parallel profiling tumor-specific mutations. We applied the technology to a prospective cohort of 110 GC patients. The technology showed ultra-high sensitivity by successfully detecting all the 27 cases that developed PD. The minimal residual cancer cells in PLF was associated with an increased risk of PD (HR = 145.13; 95%CI = 20.20-18435.79; p < 0.001) and significantly shorter overall survival. In pathologically high-risk (T4) patients, the PLF mutation profiling model exhibited even greater specificity of 91% and positive predictive value of 88%, while retaining sensitivity of 100%. PLF cancer cell fraction remained the strongest independent predictor of PD and recurrence-free survival over pathologic diagnosis and cytological diagnosis in GC patients. This approach may help in the postsurgical management of GC patients by detecting PD far before the metastatic lesions grow to significant size detectable by conventional methods such as MRI and CT scanning.

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Gastric Cancer Cells in Peritoneal Lavage Fluid: A Systematic Review Comparing Cytological with Molecular Detection for Diagnosis of Peritoneal Metastases and Prediction of Peritoneal Recurrences

Anticancer Research ◽

10.21873/anticanres.12347 ◽

2018 ◽

Vol 38 (3) ◽

Cited By ~ 1

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Cancer Cells ◽

Molecular Detection ◽

Peritoneal Lavage ◽

Lavage Fluid ◽

Peritoneal Metastases ◽

Gastric Cancer Cells ◽

Peritoneal Lavage Fluid

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Personalized analysis of minimal residual cancer cells in peritoneal lavage fluid predicts peritoneal dissemination of gastric cancer

Journal of Hematology & Oncology ◽

10.1186/s13045-021-01175-2 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Dongbing Zhao ◽

Pinli Yue ◽

Tongbo Wang ◽

Pei Wang ◽

Qianqian Song ◽

...

Keyword(s):

Gastric Cancer ◽

High Risk ◽

Cancer Cells ◽

Peritoneal Lavage ◽

Peritoneal Dissemination ◽

Lavage Fluid ◽

Residual Cancer ◽

Peritoneal Lavage Fluid ◽

Minimal Residual Cancer ◽

Minimal Residual

AbstractPeritoneal dissemination (PD) is a major type of gastric cancer (GC) recurrence and leads to rapid death. Current approaches cannot precisely determine which patients are at high risk of PD to provide early intervention. In this study, we developed a technology to detect minimal residual cancer cells in peritoneal lavage fluid (PLF) samples with a personalized assay profiling tumor-specific mutations. In a prospective cohort of 104 GC patients, the technology detected all the cases that developed PD with 100% sensitivity and 85% specificity. The minimal residual cancer cells in PLF were associated with a significantly increased risk of PD (HR = 145.13; 95% CI 20.20–18,435.79; p < 0.001), which was the strongest independent predictor over pathologic diagnosis and cytological diagnosis. In pathologically high-risk (pT4) patients, the PLF mutation profiling model exhibited a greater specificity of 91% and a positive predictive value of 88% while retaining a sensitivity of 100%. This approach may help in the postsurgical management of GC patients by detecting PD far before metastatic lesions grow to a significant size detectable by conventional methods such as MRI and CT scanning.

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Role and Regulation of Adipokines during Zymosan-Induced Peritoneal Inflammation in Mice

Endocrinology ◽

10.1210/en.2008-0327 ◽

2008 ◽

Vol 149 (8) ◽

pp. 4080-4085 ◽

Cited By ~ 20

Author(s):

Maria Pini ◽

Melissa E. Gove ◽

Joseph A. Sennello ◽

Jantine W. P. M. van Baal ◽

Lawrence Chan ◽

...

Keyword(s):

Inflammatory Infiltrate ◽

Peritoneal Lavage ◽

Lavage Fluid ◽

Wild Type ◽

Cellular Infiltrate ◽

Peritoneal Lavage Fluid ◽

Peritoneal Inflammation ◽

Leptin Deficiency ◽

Cytokine Levels

Adipokines, cytokines mainly produced by adipocytes, are active participants in the regulation of inflammation. Administration of zymosan (ZY) was used to investigate the regulation and role of adipokines during peritonitis in mice. Injection of ZY led to a significant increase in leptin levels in both serum and peritoneal lavage fluid, whereas a differential trend in local vs. systemic levels was observed for both resistin and adiponectin. The role of leptin in ZY-induced peritonitis was investigated using leptin-deficient ob/ob mice, with and without reconstitution with exogenous leptin. Leptin deficiency was associated with delayed resolution of peritoneal inflammation induced by ZY, because ob/ob mice had a more pronounced cellular infiltrate in the peritoneum as well as higher and prolonged local and systemic levels of IL-6, TNFα, IL-10, and chemokine (C-X-C motif) ligand 2 compared with wild-type mice. Reconstitution with exogenous leptin exacerbated the inflammatory infiltrate and systemic IL-6 levels in ob/ob mice while inhibiting production of TNFα, IL-10, and chemokine (C-X-C motif) ligand 2. In contrast with the important role of leptin in regulating each aspect of ZY-induced peritonitis, adiponectin deficiency was associated only with a decreased inflammatory infiltrate, without affecting cytokine levels. These findings point to a complex role for adipokines in ZY-induced peritonitis and further emphasize the interplay between obesity and inflammation.

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ALKALINE PHOSPHATASE LEVELS IN DIAGNOSTIC PERITONEAL LAVAGE FLUID AS A PREDICTOR OF HOLLOW VISCERAL INJURY

Journal of Trauma and Acute Care Surgery ◽

10.1097/00005373-199306000-00014 ◽

1993 ◽

Vol 34 (6) ◽

pp. 829-833 ◽

Cited By ~ 30

Author(s):

Jonathan H. Jaffin ◽

M. Gage Ochsner ◽

Frederic J. Cole ◽

Grace S. Rozycki ◽

Mary Kass ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Peritoneal Lavage ◽

Lavage Fluid ◽

Diagnostic Peritoneal Lavage ◽

Visceral Injury ◽

Peritoneal Lavage Fluid ◽

Hollow Visceral Injury

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Subclinical cancer cell dissemination in peritoneal lavage fluid detected by reverse-transcription polymerase chain reaction identifies patients at high risk for peritoneal recurrence and consequent impaired survival in the setting of preoperative chemoradiation therapy for pancreatic cancer

Surgery ◽

10.1016/j.surg.2018.06.047 ◽

2018 ◽

Vol 164 (6) ◽

pp. 1168-1177 ◽

Cited By ~ 6

Author(s):

Hidenori Takahashi ◽

Hirofumi Akita ◽

Hiroshi Wada ◽

Akira Tomokuni ◽

Kei Asukai ◽

...

Keyword(s):

Pancreatic Cancer ◽

Peritoneal Lavage ◽

Lavage Fluid ◽

Preoperative Chemoradiation ◽

Chemoradiation Therapy ◽

Chain Reaction ◽

Peritoneal Lavage Fluid ◽

Preoperative Chemoradiation Therapy ◽

Polymerase Chain ◽

Cell Dissemination

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Effects of peritoneal lavage fluid from radiation or/and burn injured rats on the growth of hematopoietic progenitor cells

International Journal of Radiation Biology ◽

10.1080/09553000802061277 ◽

2008 ◽

Vol 84 (6) ◽

pp. 499-504 ◽

Cited By ~ 2

Author(s):

Xin-Ze Ran ◽

Yong-ping Su ◽

Zhao-wen Zong ◽

Chun-meng Shi ◽

Chao-hua Guo ◽

...

Keyword(s):

Progenitor Cells ◽

Peritoneal Lavage ◽

Lavage Fluid ◽

Hematopoietic Progenitor Cells ◽

Hematopoietic Progenitor ◽

Peritoneal Lavage Fluid

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Virulence of Listeria monocytogenes Serovars and Listeria spp. in Experimental Infection of Mice

Journal of Food Protection ◽

10.4315/0362-028x-54.12.917 ◽

1991 ◽

Vol 54 (12) ◽

pp. 917-921 ◽

Cited By ~ 31

Author(s):

ALAIN MENUDIER ◽

CLAUDINE BOSIRAUD ◽

JEAN-ALBERT NICOLAS

Keyword(s):

Listeria Monocytogenes ◽

Peritoneal Lavage ◽

Lavage Fluid ◽

Fixed Number ◽

Peritoneal Lavage Fluid ◽

Listeria Ivanovii ◽

Wild Strains ◽

Camp Test ◽

Listeria Seeligeri ◽

Listeria Welshimeri

Wild strains of Listeria monocytogenes, Listeria ivanovii, Listeria seeligeri, Listeria innocua, and Listeria welshimeri were isolated from infected animals and foodstuffs. Their virulence was tested in Swiss mice after intraperitoneal injection of a fixed number of organisms. The presence of hemolysin was determined using the CAMP test. Bacteria were enumerated in peritoneal lavage fluid, liver, and spleen. Spleen weights were measured, and the presence of L. monocytogenes in the brain was also investigated. L. innocua, L. seeligeri, and L. welshimeri were not found to be pathogenic for mice. L. ivanovii was detected in liver, spleen, and peritoneal lavage fluid but at lower levels than L. monocytogenes (p<0.001). The pathogenic capabilities of four different serovars of L. monocytogenes (4b, 1/2a, 1/2b, 1/2c) were compared. Serovars l/2b and l/2c, which are frequently isolated from foodstuffs, were found to colonize the liver and spleen to a lesser extent than serovar 4b (p<0.01 and <0.001 respectively). The behavior of serovar l/2a, the most commonly isolated from foodstuffs, was strain dependent. Two out of the four strains tested were strongly hemolytic and were as virulent as strains of serovar 4b, while the other two were weakly hemolytic, and avirulent like L. innocua. These results could account for the relatively small number of human Listeria infections due to L. monocytogenes serogroup 1/2, despite the very frequent occurrence of this serovar in foodstuffs.

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