The detection of microscopically disseminated cancer cells in the abdominal cavity by intraoperative lavage cytology combined with an immunocytochemical method in gastric cancer.

This study was conducted to clarify the possible role of the immunocytochemical examination of intraoperative lavage cytology in gastric cancer. The expression of CA19-9, STN, SLX and CEA in tissues were examined in 70 patients with advanced gastric cancer who underwent gastric resection. The tissue sections were processed with the hematoxylin and eosin staining and immunostaining using the avidin-biotin-peroxidase complex (ABC) method. Fifty one patients underwent the lavage cytology. The cytologic samples were stained by the conventional Papanicolau method and ABC immunocytochemical method. Expression of CEA was detected at obviously higher frequency than those of the 3 carbohydrate antigens. The method combined with 4 antibodies increased the detection rate to 97.2%. Conventional lavage cytology was positive in 16 out of 51 patients. The diagnosis of class III in four patients was changed to class V through the immunocytochemical examination. The immunocytochemical examination of lavage cytology is very useful to verify the microscopically disseminated cancer cells in gastric cancer.