Open AccessProspective study to validate the clinical utility of DNA diagnosis of peritoneal fluid cytology test in gastric cancer
Author(s) -
Harada Hiroki,
Soeno Takafumi,
Nishizawa Nobuyuki,
Washio Marie,
Sakuraya Mikiko,
Ushiku Hideki,
Niihara Masahiro,
Hosoda Kei,
Kumamoto Yusuke,
Naitoh Takeshi,
Sangai Takafumi,
Hiki Naoki,
Yamashita Keishi
Publication year - 2021
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.14850
Subject(s) - dna methylation , cancer , carcinoembryonic antigen , cytology , gastroenterology , concordance , medicine , biology , microbiology and biotechnology , pathology , gene , genetics , gene expression
The clinical efficacy of DNA cytology test (CY) in gastric cancer (GC) has been retrospectively proposed using cancer‐specific methylation of cysteine dioxygenase type 1 ( CDO1) . We confirmed the clinical utility of DNA CY in a prospective cohort. Four hundred GC samples were prospectively collected for washing cytology (UMIN000026191), and detection of the DNA methylation of CDO1 was assessed by quantitative methylation‐specific PCR in the sediments. Endpoint was defined as the match rate between conventional CY1 and DNA CY1 (diagnostic sensitivity), and the DNA CY0 rate (diagnostic specificity) in pStage IA. DNA CY1 was detected in 45 cases (12.5%), while CY1 was seen in 31 cases (8.6%) of 361 chemotherapy‐naïve samples, where the sensitivity and specificity of the DNA CY in the peritoneal solutions were 74.2% and 96.5%, respectively. The DNA CY was positive for 3.5/0/4.9/11.4/58.8% in pStage IA/IB/II/III/IV, respectively ( P < .01). In the multivariate analysis, DNA CY1 was independently correlated with pathological tumor depth (pT) ( P = .0012), female gender ( P = .0099), CY1 ( P = .0135), P1 ( P = .019), and carcinoembryonic antigen (CEA) ( P = .036). The combination of DNA CY1 and P factor nearly all covered the potential peritoneal dissemination (P1 and/or CY1 and/or DNA CY1) (58/61:95.1%). DNA CY1 had a significantly poorer prognosis than DNA CY0 in GC patients ( P < .0001). DNA CY1 detected by CDO1 promoter DNA methylation has a great value to detect minimal residual disease of the peritoneum in GC clinics, representing poor prognosis as a novel single DNA marker.