Molecular diagnosis and therapy for occult peritoneal metastasis in gastric cancer patients
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摘要
To apply an individualized oncological approach to gastric cancer patients,the accurate diagnosis of disease entities is required.Peritoneal metastasis is the most frequent mode of metastasis in gastric cancer,and the tumor-node-metastasis classification includes cytological detection of intraperitoneal cancer cells as part of the staging process,denoting metastatic disease.The accuracy of cytological diagnosis leaves room for improvement;therefore,highly sensitive molecular diagnostics,such as an enzyme immunoassay,reverse transcription polymerase chain reaction,and virusguided imaging,have been developed to detect minute cancer cells in the peritoneal cavity.Molecular targeting therapy has also been spun off from basic research in the past decade.Although conventional cytologyis still the mainstay,novel approaches could serve as practical complementary diagnostics to cytology in near future.
To apply an individualized oncological approach to gastric cancer patients,the accurate diagnosis of disease entities is required.Peritoneal metastasis is the most frequent mode of metastasis in gastric cancer,and the tumor-node-metastasis classification includes cytological detection of intraperitoneal cancer cells as part of the staging process,denoting metastatic disease.The accuracy of cytological diagnosis leaves room for improvement;therefore,highly sensitive molecular diagnostics,such as an enzyme immunoassay,reverse transcription polymerase chain reaction,and virusguided imaging,have been developed to detect minute cancer cells in the peritoneal cavity.Molecular targeting therapy has also been spun off from basic research in the past decade.Although conventional cytologyis still the mainstay,novel approaches could serve as practical complementary diagnostics to cytology in near future.
To apply an individualized oncological approach to gastric cancer patients,the accurate diagnosis of disease entities is required.Peritoneal metastasis is the most frequent mode of metastasis in gastric cancer,and the tumor-node-metastasis classification includes cytological detection of intraperitoneal cancer cells as part of the staging process,denoting metastatic disease.The accuracy of cytological diagnosis leaves room for improvement;therefore,highly sensitive molecular diagnostics,such as an enzyme immunoassay,reverse transcription polymerase chain reaction,and virusguided imaging,have been developed to detect minute cancer cells in the peritoneal cavity.Molecular targeting therapy has also been spun off from basic research in the past decade.Although conventional cytologyis still the mainstay,novel approaches could serve as practical complementary diagnostics to cytology in near future.
引文
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2 Bray F,Ren JS,Masuyer E,Ferlay J.Global estimates of cancer prevalence for 27 sites in the adult population in 2008.Int J Cancer 2013;132:1133-1145[PMID:22752881 DOI:10.1002/ijc.27711]
3 Coburn N,Seevaratnam R,Paszat L,Helyer L,Law C,Swallow C,Cardosa R,Mahar A,Lourenco LG,Dixon M,BekaiiSaab T,Chau I,Church N,Coit D,Crane CH,Earle C,Mansfield P,Marcon N,Miner T,Noh SH,Porter G,Posner MC,Prachand V,Sano T,van de Velde C,Wong S,Mc Leod R.Optimal management of gastric cancer:results from an international RAND/UCLA expert panel.Ann Surg 2014;259:102-108[PMID:23478525 DOI:10.1097/SLA.0b013e318288dd2b]
4 Brar SS,Mahar AL,Helyer LK,Swallow C,Law C,Paszat L,Seevaratnam R,Cardoso R,Mc Leod R,Dixon M,Yohanathan L,Lourenco LG,Bocicariu A,Bekaii-Saab T,Chau I,Church N,Coit D,Crane CH,Earle C,Mansfield P,Marcon N,Miner T,Noh SH,Porter G,Posner MC,Prachand V,Sano T,van de Velde C,Wong S,Coburn NG.Processes of care in the multidisciplinary treatment of gastric cancer:results of a RAND/UCLA expert panel.JAMA Surg 2014;149:18 -25[PMID:24225775 DOI:10.1001/jamasurg.2013.3959]
5 Washington K.7th edition of the AJCC cancer staging manual:stomach.Ann Surg Oncol 2010;17:3077-3079[PMID:20882416DOI:10.1245/s10434-010-1362-z]
6 Sobin L GM,Wittekind C.TNM Classification of Malignant Tumours,7th ed.Oxford:Wiley-Blackwell,2009
7 Lee SD,Ryu KW,Eom BW,Lee JH,Kook MC,Kim YW.Prognostic significance of peritoneal washing cytology in patients with gastric cancer.Br J Surg 2012;99:397-403[PMID:22101572DOI:10.1002/bjs.7812]
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