Intraoperative flow cytometry in detecting free carcinoma cells in peritoneal lavage fluid of gastric carcinoma cases
Year: 2025
Type: article
Study design: Observational Study
Abstract: The free carcinoma cells (FCC) in peritoneal lavage fluid are an independent adverse prognostic factor in patients with gastric carcinoma. Detection of FCC in the pre-operative peritoneal lavage fluid is critical, as patients with FCC do not have a survival advantage with curative cytoreductive (CCR) surgery. Cytology is currently used to assess FCC, but its sensitivity is poor and there is a need for better sensitive techniques. We attempted to study the efficiency of intra-operative flow cytometry (FCM) in detecting FCC in peritoneal lavage fluid of gastric carcinoma patients. In this prospective study, 32 peritoneal lavage fluids were analyzed intra-operatively by cytology and FCM. The median time taken for sample processing was 47 min. The concordance was achieved in 84% (27/32) of samples. FCM detected FCC in 17 peritoneal lavage fluids, of which only 12 were reported positive by cytology. Five cases that had a FCC burden of less than 0.01% were reported negative by cytology. FCC with programmed death-ligand 1 (PD-L1) expression of greater than 50% was noted in 12 cases. Intra-operative FCM improves the detection of FCC in peritoneal lavage fluid compared to cytology. Due to higher sensitivity, flow cytometry offers a promising adjuvant to cytology and helps in deciding on judicious radical CCR.
DOI: 10.1002/cyto.b.22238
Authors: Thulasi Raman Ramalingam, Bharaneedharan Marimuthu, Harsha N. Rasheed, Archana Lakshmanan, Swetha Lakshmi Narla, Lakshman Vaidhyanathan, Ajit Pai
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,800
OpenAlex ID: W4410745132