Cancer cells with p53 deletion detected by fluorescent in situ hybridization in peritoneal drainage fluid is correlated with early peritoneal seeding in resectable pancreatic cancer.
10.4174/jkss.2013.84.4.209
- Author:
Mee Joo KANG
1
;
Sung Sik HAN
;
Jin Young JANG
;
Jae Woo PARK
;
Wooil KWON
;
Ye Rim CHANG
;
Sun Whe KIM
Author Information
1. Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. sunkim@plaza.snu.ac.kr, jangjy4@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Pancreatic neoplsms;
Peritoneal fluid;
Fluorescent in situ hybridization;
p53 gene
- MeSH:
Ascitic Fluid;
Drainage;
Follow-Up Studies;
Genes, p53;
Humans;
In Situ Hybridization, Fluorescence;
Neoplasm Metastasis;
Pancreatic Neoplasms;
Recurrence;
Risk Factors;
Seeds
- From:Journal of the Korean Surgical Society
2013;84(4):209-215
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Free tumor cells in peritoneal fluid in patients with pancreatic cancer may have prognostic significance but there are few reports on methods for the effective detection of free tumor cells. The aims of this study were to identify free cancer cells in peritoneal fluid with fluorescent in situ hybridization (FISH) technique and to investigate its prognostic significance. METHODS: Twenty-eight patients with resectable pancreatic cancer who underwent surgical resection were included. Peritoneal washing and peritoneal drainage fluid were examined by FISH for p53 deletion. RESULTS: Among the study subjects, the R0 resection rate was 75%. None of the patients had positive cytology with Papanicolaou's method. p53 deletion was detected in 9 peritoneal washings (32.1%) and in 5 peritoneal drainage fluids (17.9%). After a median of 18 months of follow-up, 25 patients (89.3%) experienced recurrence and 14 patients (50.0%) had peritoneal seeding. Patients with p53 deletion detected in the peritoneal drainage fluid had positive radial margin (60.0% vs. 17.4%, P = 0.046) more frequently and a lower peritoneal metastasis free survival (median, 11.1 months vs. 30.3 months; P = 0.030). Curative resection (P < 0.001) and p53 deletion in peritoneal drainage fluid (P = 0.030) were independent risk factors of peritoneal metastasis free survival after multivariate analysis. CONCLUSION: FISH technique detects free cancer cells with higher sensitivity compared to Papanicolaou's method. p53 deletion detected in peritoneal drainage fluid is correlated with positive radial resection margin and results in early peritoneal seeding. Patients with p53 deletion in peritoneal drainage fluid need more aggressive adjuvant treatment.
