Significance and Usefulness of Peritoneal-irrigation Cytology with Application of the Carcinoembryonic Antigen Releasing Method of by Phosphatidylinositol Phospholipase C

Kyoshi Tsuji, Takashi Suhara, Motohisa Kato, Hiroshi Takao, Yasuyuki Sugiyama, Katsuyuki Kunieda, Takao Umemoto, Kiichi Miya, Daizo Fukada, Shigetoyo Saji

Second Department of Surgery, Gifu University School of Medicined

To obtain an early diagnosis of peritoneal dissemination of gastric cancer, the usefulness a novel method employing the release of carcinoembryonic antigen (CEA) from cancer cells via peritoneal irrigation with phosphatidylinositol phospholipase C (PI-PLC) was evaluated experimentally and clinically. Experimental study: 1) The CEA value was increased about 1.7 fold by PI-PLC against KATO-III CEA secreting cancer cells. 2) The CEA value increase depended on the duration of incubation with PI-PLC and the number of target cells. 3) The CEA value was increased by combination with trypsin. Clinical study: Three kinds of irrigation cytology were performed at laparotomy on 81 gastric cancer patients, that is irrigation cytology (IR), cell CEA stain (cCEA) and PI-PLC. 1) The positive rate for 12 patients with macroscopic peritoneal dissemination (P) was 91% for IR, 75% for cCEA and 83% for PI-PLC, while corresponding values were 2.9%, 4.3% and 7.2%, respectively, in 69 cases without P. 2) CEA sensitivity ranged from 1.8 times to 600 times, and the characteristic of showing positivity on PI-PLC suggested microscopic peritoneal dissemination reflected by clinico-pathological findings, From the above results, it is suggested that PI-PLC is a potentially useful method of objectively detecting early peritoneal dissemination.

Key words
gastric cancer, peritoneal metastasis, carcinoembryonic antigen, phosphatidylinositol phospholipase C

Reprint requests
Kyoshi Tsuji Second Department of Surgery, School of Medicine, Gifu University
40 Tsukasa-machi, Gifu, 500 JAPAN

Accepted
March 19, 1997

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