Preoperative Cytology and Measurement of Cancer Antigen 125 in Recovered Fluid from Saline Injected Peritoneal Cavity in Gastric Cancer

Masashi Kato, Toshiharu Sawa, Kazuo Kinoshita, Yasuharu Nakano, Kazuo Kitabayashi, Sotohiro Yoshimitsu

Department of Surgery, National Sanatorium Tsuruga Hospital

We infused physiological saline into the abdominal cavity and performed preoperative peritoneal cytology (PPC) and measurement of CA 125 in the recovered fluid in 54 patients with gastric cancer in whom no peritoneal tumor or ascites was observed by palpation, US, or CT. In the diagnosis of peritoneal dissemination, the sensitivity, specificity and accuracy of PPC were 60%, 95.5% and 88.9%, respectively. These figures were similar to those for peritoneal lavage cytology. The CA 125 level in the recovered fluid correlated well with the serum CAL125 level in P (+) patients. The CA 125 level in the serum did not differ significantly between ps (+) patients and ps (-) patients, but that in the recovered fluid was significantly higher in the ps (+) patients (10^1.61±0.46U/ml) than in the ps (-) patients (10^1.33±0.25U/ml). No complications of this examination were observed. These results suggest that PPC and measurement of CA 125 in recovered fluid are very useful for preoperatively diagnosing peritoneal dissemination.

Key words
gastric cancer, peritoneal dissemination, preoperative peritoneal cytology, cancer antigen 125

Reprint requests
Masashi Kato Department of Surgery II, Kanazawa Medical University
Uchinada-machi, Kahoku-gun, Ishikawa, 920-02 JAPAN

Accepted
October 9, 1991

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