Potential for peritoneal cancer cell seeding in endoscopic full-thickness resection for early gastric cancer

Osamu Goto, Masayuki Shimoda, Motoki Sasaki, Yoshiyuki Kiguchi, Yutaka Mitsunaga, Teppei Akimoto, Yasutoshi Ochiai, Ai Fujimoto, Tadateru Maehata, Toshihiro Nishizawa, Hiroya Takeuchi, Yuukou Kitagawa, Kaori Kameyama, Naohisa Yahagi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background and Aims: During endoscopic full-thickness resection (EFTR) for cancers, whether exposure of the lumen to the abdominal cavity during the procedure is acceptable is controversial because of the potential risk of tumor cell seeding. To assess the possibility of transplantation as a result of contact with tumor cells during the procedure, we prospectively investigated the ability of cancer cells to be detached by touching the tumor surface. Methods: In 48 patients with a single early gastric cancer resected by endoscopic submucosal dissection, stamp cytology was performed by touching the surface of the specimens to glass slides. Samples were obtained from cancerous and noncancerous areas, constituting the study and control groups, respectively. The detection rate of malignant class IV or V (C-IV/C-V) samples was investigated with Papanicolaou staining. The rate of CD44v9-positive cases, a cancer stem cell marker, was assessed in C-IV/C-V samples with immunohistochemical staining. Results: Detection rates of C-IV/C-V samples in the cancerous group (53/192 slides, 27.6%) differed significantly from those of the C-IV/C-V samples in the noncancerous group (0/96 slides, 0%). Among the 53 slides of C-IV/C-V samples in the cancerous group, CD44v9 cells were expressed in 18 slides (34.0%). Conclusions: These data suggest that cancer cells, including cancer stem cells, in early gastric cancers are easily detached via contact with the tumor surface. In EFTR, a nonexposure approach is recommended to avoid the risk of iatrogenic cancer cell seeding via contact with and transplantation of cancer cells.

Original languageEnglish
JournalGastrointestinal Endoscopy
DOIs
Publication statusAccepted/In press - 2017

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Stomach Neoplasms
Neoplasms
Neoplastic Stem Cells
Staining and Labeling
Abdominal Cavity
Cell Transplantation
Glass
Cell Biology
Transplantation
Control Groups

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Potential for peritoneal cancer cell seeding in endoscopic full-thickness resection for early gastric cancer. / Goto, Osamu; Shimoda, Masayuki; Sasaki, Motoki; Kiguchi, Yoshiyuki; Mitsunaga, Yutaka; Akimoto, Teppei; Ochiai, Yasutoshi; Fujimoto, Ai; Maehata, Tadateru; Nishizawa, Toshihiro; Takeuchi, Hiroya; Kitagawa, Yuukou; Kameyama, Kaori; Yahagi, Naohisa.

In: Gastrointestinal Endoscopy, 2017.

Research output: Contribution to journalArticle

Goto, Osamu ; Shimoda, Masayuki ; Sasaki, Motoki ; Kiguchi, Yoshiyuki ; Mitsunaga, Yutaka ; Akimoto, Teppei ; Ochiai, Yasutoshi ; Fujimoto, Ai ; Maehata, Tadateru ; Nishizawa, Toshihiro ; Takeuchi, Hiroya ; Kitagawa, Yuukou ; Kameyama, Kaori ; Yahagi, Naohisa. / Potential for peritoneal cancer cell seeding in endoscopic full-thickness resection for early gastric cancer. In: Gastrointestinal Endoscopy. 2017.
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abstract = "Background and Aims: During endoscopic full-thickness resection (EFTR) for cancers, whether exposure of the lumen to the abdominal cavity during the procedure is acceptable is controversial because of the potential risk of tumor cell seeding. To assess the possibility of transplantation as a result of contact with tumor cells during the procedure, we prospectively investigated the ability of cancer cells to be detached by touching the tumor surface. Methods: In 48 patients with a single early gastric cancer resected by endoscopic submucosal dissection, stamp cytology was performed by touching the surface of the specimens to glass slides. Samples were obtained from cancerous and noncancerous areas, constituting the study and control groups, respectively. The detection rate of malignant class IV or V (C-IV/C-V) samples was investigated with Papanicolaou staining. The rate of CD44v9-positive cases, a cancer stem cell marker, was assessed in C-IV/C-V samples with immunohistochemical staining. Results: Detection rates of C-IV/C-V samples in the cancerous group (53/192 slides, 27.6{\%}) differed significantly from those of the C-IV/C-V samples in the noncancerous group (0/96 slides, 0{\%}). Among the 53 slides of C-IV/C-V samples in the cancerous group, CD44v9 cells were expressed in 18 slides (34.0{\%}). Conclusions: These data suggest that cancer cells, including cancer stem cells, in early gastric cancers are easily detached via contact with the tumor surface. In EFTR, a nonexposure approach is recommended to avoid the risk of iatrogenic cancer cell seeding via contact with and transplantation of cancer cells.",
author = "Osamu Goto and Masayuki Shimoda and Motoki Sasaki and Yoshiyuki Kiguchi and Yutaka Mitsunaga and Teppei Akimoto and Yasutoshi Ochiai and Ai Fujimoto and Tadateru Maehata and Toshihiro Nishizawa and Hiroya Takeuchi and Yuukou Kitagawa and Kaori Kameyama and Naohisa Yahagi",
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T1 - Potential for peritoneal cancer cell seeding in endoscopic full-thickness resection for early gastric cancer

AU - Goto, Osamu

AU - Shimoda, Masayuki

AU - Sasaki, Motoki

AU - Kiguchi, Yoshiyuki

AU - Mitsunaga, Yutaka

AU - Akimoto, Teppei

AU - Ochiai, Yasutoshi

AU - Fujimoto, Ai

AU - Maehata, Tadateru

AU - Nishizawa, Toshihiro

AU - Takeuchi, Hiroya

AU - Kitagawa, Yuukou

AU - Kameyama, Kaori

AU - Yahagi, Naohisa

PY - 2017

Y1 - 2017

N2 - Background and Aims: During endoscopic full-thickness resection (EFTR) for cancers, whether exposure of the lumen to the abdominal cavity during the procedure is acceptable is controversial because of the potential risk of tumor cell seeding. To assess the possibility of transplantation as a result of contact with tumor cells during the procedure, we prospectively investigated the ability of cancer cells to be detached by touching the tumor surface. Methods: In 48 patients with a single early gastric cancer resected by endoscopic submucosal dissection, stamp cytology was performed by touching the surface of the specimens to glass slides. Samples were obtained from cancerous and noncancerous areas, constituting the study and control groups, respectively. The detection rate of malignant class IV or V (C-IV/C-V) samples was investigated with Papanicolaou staining. The rate of CD44v9-positive cases, a cancer stem cell marker, was assessed in C-IV/C-V samples with immunohistochemical staining. Results: Detection rates of C-IV/C-V samples in the cancerous group (53/192 slides, 27.6%) differed significantly from those of the C-IV/C-V samples in the noncancerous group (0/96 slides, 0%). Among the 53 slides of C-IV/C-V samples in the cancerous group, CD44v9 cells were expressed in 18 slides (34.0%). Conclusions: These data suggest that cancer cells, including cancer stem cells, in early gastric cancers are easily detached via contact with the tumor surface. In EFTR, a nonexposure approach is recommended to avoid the risk of iatrogenic cancer cell seeding via contact with and transplantation of cancer cells.

AB - Background and Aims: During endoscopic full-thickness resection (EFTR) for cancers, whether exposure of the lumen to the abdominal cavity during the procedure is acceptable is controversial because of the potential risk of tumor cell seeding. To assess the possibility of transplantation as a result of contact with tumor cells during the procedure, we prospectively investigated the ability of cancer cells to be detached by touching the tumor surface. Methods: In 48 patients with a single early gastric cancer resected by endoscopic submucosal dissection, stamp cytology was performed by touching the surface of the specimens to glass slides. Samples were obtained from cancerous and noncancerous areas, constituting the study and control groups, respectively. The detection rate of malignant class IV or V (C-IV/C-V) samples was investigated with Papanicolaou staining. The rate of CD44v9-positive cases, a cancer stem cell marker, was assessed in C-IV/C-V samples with immunohistochemical staining. Results: Detection rates of C-IV/C-V samples in the cancerous group (53/192 slides, 27.6%) differed significantly from those of the C-IV/C-V samples in the noncancerous group (0/96 slides, 0%). Among the 53 slides of C-IV/C-V samples in the cancerous group, CD44v9 cells were expressed in 18 slides (34.0%). Conclusions: These data suggest that cancer cells, including cancer stem cells, in early gastric cancers are easily detached via contact with the tumor surface. In EFTR, a nonexposure approach is recommended to avoid the risk of iatrogenic cancer cell seeding via contact with and transplantation of cancer cells.

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U2 - 10.1016/j.gie.2017.08.036

DO - 10.1016/j.gie.2017.08.036

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C2 - 28890117

AN - SCOPUS:85032226376

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

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