Ricerc@Sapienza

Differently from other digestive malignancies, gastric cancer (GC) pathobiology is still little known and understood. Recently, cytopathology and molecular biology on gastric juice/gastric lavage (GJ/GL) of GC patients have provided novel and interesting results in terms of screening, diagnosis, prognosis, and therapy. However, entertaining cytologic examination and molecular test as a unified solo-run test is previously unreported. Our aim was to assess the new parameter "GL Ca 72.4" for GC patients.

In addition to classical metastatic pathways, recently gastric cancer was described having an alternative route
called “endoluminal exfoliation”. Provisional analyses demonstrated, in fact, this kind of shedding is associated
with several clinico-pathological features indicative of aggressive behavior and resulted to be an independent
prognostic factor entailing poor prognosis. Compared with non-sowing counterparts, in fact, patients affected
with exfoliating early and advanced gastric carcinomas met with shorter overall survival, disease free survival,

OBJECTIVE:
As of 2017, the pathobiology of gastric cancer (GC) is far from fully understood; consequently, new methods of basic and advanced research have been proposed and tested. The presence (GL1) vs absence (GL0) of malignant cells exfoliated in gastric lavage (GL) of GC patients was formerly evaluated with diagnostic intent but not for staging or prognostic assessment. We investigated this hitherto unreported application of cytopathology.

BACKGROUND/AIM:
Concerning gastric cancer (GC), nasogastric tube (NGT) is routinely employed for peri-operative decompression and palliative enteral nutrition. Additionally, we believe to have found a further application.

PATIENTS AND METHODS:
Between April 2012 and April 2017, 96 GC patients received preoperative nasogastric lavage (GL). All samples were cytologically examined to detect the presence (GL1) or absence (GL0) of malignant cells. Data were analyzed with classificatory, staging and prognostic purpose.

Historically, analysis of intragastric exfoliative cytology (IEC) of gastric cancer (GC) was used with diagnostic intent only. With the successful advent of endoscopic biopsy, the rate of detection of GC has improved worldwide and, as a consequence, IEC has been progressively abandoned. Today, however, there is a renewed interest in this field of research as witnessed by several pertinent publications. As discussed in this review, in fact, currently the importance of analyzing IEC in patients with early and advanced GC seems to reside in its clinicopathological and prognostic significance.

BACKGROUND/AIM:
Although reckoned necessary for survival benefit, neoadjuvant chemotherapy (NAC) of gastric cancer (GC) patients has so far provided questionable results. Consequently, searching for new and clearer systems of response to NAC, post-NAC re-evaluation and prognostic prediction appears essential. The purpose of this study was to examine endogastric cytopathology and hemoglobin level count as new features, potentially useful for GC patients after NAC.

BACKGROUND/AIM:
Early gastric cancer (EGC) is usually associated with excellent prognosis. Some cases, however, entail a poorer survival. Our aim was to assess if EGC exfoliating into gastric lavage (GL) has a more aggressive behavior than the non-exfoliative counterpart.
PATIENTS AND METHODS:
Between April 2012 and April 2017, 96 gastric cancer patients were prospectively submitted to preoperative GL to detect the presence (GL1) or absence (GL0) of exfoliated malignant cells.
RESULTS:

As of 2017, no serum tumor marker has shown high levels of sensitivity or specificity for early detection, classification, staging, prediction and prognosis of patients affected by gastric cancer. In this regard, since 1975 several authors have investigated the gastric juice or gastric lavage of patients with gastric adenocarcinoma in order to determine the concentrations of intragastric tumor markers and discover the perfect antigen for this cancer. To date, however, a systematic review of the literature on intragastric tumor markers is still unreported.