Clinical Significance of Detection of Carcinoembryonic Antigen in Peritoneal Fluid by Reverse Transcription-Polymerase Chain Reaction in Patients with Gastric Cancer

PURPOSE: Free cancer cells in the peritoneal cavity exfoliated from a tumor are considered to be responsible for peritoneal dissemination in gastric cancer. To detect free cancer cells, a carcinoembryonic antigen (CEA) was introduced to the marker of gastric cancer. The clinical significance of detecting the carcinoembryonic antigen (CEA) mRNA in the peritoneal fluid was evaluated by RT-PCR in patients with gastric cancer. METHODS: In 50 patients with gastric cancer who received a gastrectomy, the peritoneal washing fluids were obtained and the CEA mRNA was detected by RT-PCR and a cytological examination was taken, simultaneously. The results were correlated with the stage and the recurrence of peritoneal seeding. RESULTS: Positive values of CEA mRNA from the peritoneal washing fluids were observed in 24% (12/50) of patients with gastric cancer but of 4% (2/50) showed peritoneal cytology. There were 8 cases of peritoneal seeding in the follow-up and 6 cases of them presented positive CEA mRNA values (50%, 6/12). According to the stage, positive CEA mRNA values from the peritoneal washing fluids were found in 9% (2/21) in stage I, 20% (2/10) in stage II, 33% (5/15) in stage III and 75% (3/4) in stage IV (P=0.030). In the T classification, positive CEA mRNA values were found in 13% (2/15) in T1, 10% (1/10) in T2, 30% (7/23) in T3 and 100% (2/2) in T4 (P=0.031). In the N classification, positive CEA mRNA values were found in 15% (4/26) in N0, 20% (3/15) in N1, 40% (2/5) in N2 and 75% (3/4) in N3 (P=0.055). CONCLUSION: These results suggest that the detection of CEA mRNA by RT-PCR in peritoneal fluid of gastric cancer patients was more sensitive than the peritoneal cytology, and may have a role in selecting patients with a poor prognosis who may benefit from adjuvant therapy.

A Case of Trichosporon beigelii Esophagitis Presenting Hematemesis with a Large Amorphous Material / 대한소아소화기영양학회지

We experienced a case of Trichosporon beigelii esophagitis in a 16-month-old boy who was presented with hematemesis with a large amorphous material. A spit-out material was silky, 10 x 1.2 cm in size and like a part of hollow viscus organ. Emergent gastrofiberscopy revealed that this silky material was teared up from upper and to lower esophagus and was threw with hematemesis. It was suggested that pseudomembrane on esophagus was peeled off followed by mucosal bleeding. Pathologic study revealed this material was pseudomembrane with esophageal mucosa of T. beigelii esophagitis and was teared at lamina propria level from submucosa.

Clinical Significance of Cellular Fibronectin as a Tumor Marker in Gastric Cancer Patients

BACKGROUND : Fibronectins (FNs) are adhesive glycoproteins that have variable primary structures owing to cell type-specific splicing of the FN precursor mRNA. FNs can be classified as plasma (p-FN) and cellular (c-FN) types, and c-FN may play a role as a marker of malignancies. CEA and CA 125 have been reported as useful tumor markers, but FNs have not studied adequately in gastric cancers. METHODS : We evaluated the clinical significance of urinary and plasma c-FN in thirty-five patients who were operated on our department due to gastric cancer from January 1997 to August 1997. The c-FN level was determined by enzyme immunoassay using a FIBRONECTIN EIA kit (Takara Shuzo Co., Kyoto, Japan). RESULTS : The levels of urine c-FN in gastric cancer patients (215.6 470.2) were higher than those in the control groups (94.1 63.0 ng/mgCr) and also showed a tendency to increase with advancing of tumor growth. A higher rate of increased urine c-FN also was identified in patients with distant metastasis than in patients without distant metastasis (6/8 vs. 10/27, p=0.05). However, p-FN didn't showed any differences according to extent of tumor invasion and/or presence of distant metastasis. Other parameters, such as age, sex, preoperative tumor size, and depth of invasion, were not correlated with urine and plasma c-FN. CONCLUSIONS : Urine c-FN may be useful as a new tumor marker in gastric cancer and can be helpful in early detection of metastasis and peritoneal seeding, but further studies and follow up are needed for complete clinical application.