Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results

The presence of peritoneal free cancer cells (FCC) in gastric cancer (GC) patients is a poor prognostic factor. D2 gastrectomy may induce exfoliated FCC spread from the primary tumour or involved lymph nodes (LN). Conventional cytology for FCC detection has several limitations, whereas prophylactic...

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Autores principales:	Katarzyna Gęca, Karol Rawicz-Pruszyński, Radosław Mlak, Katarzyna Sędłak, Magdalena Skórzewska, Zuzanna Pelc, Teresa Małecka-Massalska, Wojciech P. Polkowski
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	advanced gastric cancer one-step nucleic acid amplification peritoneal washings Medicine R
Acceso en línea:	https://doaj.org/article/d7e5cf42208a4275a2bc1969e95ec821
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spelling	oai:doaj.org-article:d7e5cf42208a4275a2bc1969e95ec8212021-11-25T18:00:42ZMolecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results10.3390/jcm102252302077-0383https://doaj.org/article/d7e5cf42208a4275a2bc1969e95ec8212021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5230https://doaj.org/toc/2077-0383The presence of peritoneal free cancer cells (FCC) in gastric cancer (GC) patients is a poor prognostic factor. D2 gastrectomy may induce exfoliated FCC spread from the primary tumour or involved lymph nodes (LN). Conventional cytology for FCC detection has several limitations, whereas prophylactic use of extensive intraoperative peritoneal lavage (IPL) does not improve survival. A prospective single-arm observational study was conducted to verify whether D2 gastrectomy causes an intraoperative increase of FCC in peritoneal fluid. Twenty-seven GC patients underwent D2 gastrectomy, followed by objective quantitative measurements of CK19 mRNA level reflecting FCC with One-Step Nucleic Acid Amplification (OSNA) assay. The IPL with 3000 mL of saline was performed twice: (1) after gastrectomy with D2 lymphadenectomy and (2) after alimentary tract reconstruction. The IPL samples were analysed by initial cytology and four (1–4) consecutive OSNA assays. Initial OSNA measurement (1) revealed positive results (≥24.6 cCP/μL) in 7 (29.6%) patients. Subsequent OSNA measurements showed a significant decrease in the FCC level after D2 gastrectomy (1 vs. 2; <i>p</i> = 0.0012). The first IPL induced a non-significant increase in the FCCs (2 vs. 3, <i>p</i> = 0.3300), but the second IPL reversed it to normal levels (3 vs. 4, <i>p</i> = 0.0.0574). The OSNA assay indicates a temporal intraoperative increase in the peritoneal FCC in advanced GC patients undergoing D2 gastrectomy. Two consecutive IPLs are necessary to reverse the increase of CK19 mRNA level in peritoneal washings.Katarzyna GęcaKarol Rawicz-PruszyńskiRadosław MlakKatarzyna SędłakMagdalena SkórzewskaZuzanna PelcTeresa Małecka-MassalskaWojciech P. PolkowskiMDPI AGarticleadvanced gastric cancerone-step nucleic acid amplificationperitoneal washingsMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5230, p 5230 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	advanced gastric cancer one-step nucleic acid amplification peritoneal washings Medicine R
spellingShingle	advanced gastric cancer one-step nucleic acid amplification peritoneal washings Medicine R Katarzyna Gęca Karol Rawicz-Pruszyński Radosław Mlak Katarzyna Sędłak Magdalena Skórzewska Zuzanna Pelc Teresa Małecka-Massalska Wojciech P. Polkowski Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results
description	The presence of peritoneal free cancer cells (FCC) in gastric cancer (GC) patients is a poor prognostic factor. D2 gastrectomy may induce exfoliated FCC spread from the primary tumour or involved lymph nodes (LN). Conventional cytology for FCC detection has several limitations, whereas prophylactic use of extensive intraoperative peritoneal lavage (IPL) does not improve survival. A prospective single-arm observational study was conducted to verify whether D2 gastrectomy causes an intraoperative increase of FCC in peritoneal fluid. Twenty-seven GC patients underwent D2 gastrectomy, followed by objective quantitative measurements of CK19 mRNA level reflecting FCC with One-Step Nucleic Acid Amplification (OSNA) assay. The IPL with 3000 mL of saline was performed twice: (1) after gastrectomy with D2 lymphadenectomy and (2) after alimentary tract reconstruction. The IPL samples were analysed by initial cytology and four (1–4) consecutive OSNA assays. Initial OSNA measurement (1) revealed positive results (≥24.6 cCP/μL) in 7 (29.6%) patients. Subsequent OSNA measurements showed a significant decrease in the FCC level after D2 gastrectomy (1 vs. 2; <i>p</i> = 0.0012). The first IPL induced a non-significant increase in the FCCs (2 vs. 3, <i>p</i> = 0.3300), but the second IPL reversed it to normal levels (3 vs. 4, <i>p</i> = 0.0.0574). The OSNA assay indicates a temporal intraoperative increase in the peritoneal FCC in advanced GC patients undergoing D2 gastrectomy. Two consecutive IPLs are necessary to reverse the increase of CK19 mRNA level in peritoneal washings.
format	article
author	Katarzyna Gęca Karol Rawicz-Pruszyński Radosław Mlak Katarzyna Sędłak Magdalena Skórzewska Zuzanna Pelc Teresa Małecka-Massalska Wojciech P. Polkowski
author_facet	Katarzyna Gęca Karol Rawicz-Pruszyński Radosław Mlak Katarzyna Sędłak Magdalena Skórzewska Zuzanna Pelc Teresa Małecka-Massalska Wojciech P. Polkowski
author_sort	Katarzyna Gęca
title	Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results
title_short	Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results
title_full	Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results
title_fullStr	Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results
title_full_unstemmed	Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results
title_sort	molecular cytology by one-step nucleic acid amplification (osna) assay of peritoneal washings during d2 gastrectomy in advanced gastric cancer patients: preliminary results
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d7e5cf42208a4275a2bc1969e95ec821
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Molecular Cytology by One-Step Nucleic Acid Amplification (OSNA) Assay of Peritoneal Washings during D2 Gastrectomy in Advanced Gastric Cancer Patients: Preliminary Results

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