A Study of Combined Effects of CEA Release using Phosphatidylinositol Phospholipase C and Ultrasound-induced Cell Lysis in Early Peritoneal Dissemination on Diagnosis

Masahiro Hayakawa, Katsuyuki Kunieda, Shinichirou Aoki, Noriaki Kojima and Shigetoyo Saji

Second Department of Surgery, Gifu University, School of Medicine

Purpose: We studied the combined effects of carcinoembryonic antigen (CEA) release from cancer cell (PLC) using phosphatidylinositol phospholipase C (PIPLC) and ultrasound-induced cell lysis (US) in early peritoneal dissemination on diagnosis. Materials and Methods: Materials were 3 CEA-producing human gastric cancer cell lines-KATO-III, LoVo and MKN-45-and Subjects 46 gastric cancer patients undergoing gastrectomy and peritoneal lavage cytology for 1 year 1998. Patients were divided into 4 groups-nontreatment, PLC (0.05 U of PIPLC administered into sediment from peritoneal lavage fluid), US (ultrasound-induced cell lysis), and USP (combined PLC and US). The reaction was positive if supernatant CEA increased more than 10% compared to the nontreatment group. Results: CEA was higher in cytoplasmic KATO-III and MKN-45 than in apical LoVo. The effect of CEA release was more marked in the USP group versus cytoplasmic. Positive CEA increased gradually by surgical stage grouping and the depth of tumor invasion-23.9% in nontreatment, 26.1% in PLC, 26.1% in US, and 28.3% in USP, with USP the most positive. The prognosis of positive groups in USP, PLC, and CY was significantly poorer than in negative groups. In cases showing T2 or T3 with negative peritoneal dissemination, no significant difference was seen in survival curves between positive and negative PLC, but the prognosis of USP (+) was significantly poorer than that of USP (-). Conclusions: The combination of PLC and US, i.e.) USP, may be effective in early diagnosis of peritoneal dissemination in gastric cancer patients.

Key words
gastric cancer, peritoneal dissemination, carcinoembryonic antigen, phosphatidylinositol phospholipase C, ultrasound-induced cell lysis

Reprint requests
Masahiro Hayakawa Second Department of Sugg. Gifu University School of Medicine 40 Tsukasa-cho, Gifu, 500-8705 JAPAN

Accepted
September 25, 2002

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