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Table 1. List of published studies regarding the genetic diagnosis of peritoneal lavage cytology in gastric cancer
Study Year Marker Detection Number of Main results
method patients
Nakanishi et al. [24] 1997 CEA RT-PCR 48 RT-PCR is more sensitive for detection of free
carcinoma cells in the peritoneal cavity than
conventional cytology
Fujimura et al. [53] 1998 Trypsinogen RT-PCR 30 Trypsinogen-1 mRNA was positive for the patient,
who did not show macroscopic or cytological
peritoneal dissemination
Yonemura et al. [25] 2001 MMP-7 RT-PCR 152 Improved the sensitivity for peritoneal dissemination
in combination with cytology
Kodera et al. [34] 2002 CEA RT-PCR 90 PCR positive was a significant independent
prognostic factor, but CY positive was not
Sugita et al. [39] 2003 CEA, CK20 RT-PCR 129 In cases with negative cytology, patients with PCR-
positive findings in PLF had a poorer outcome than
those with negative PCR
Mori et al. [66] 2004 Multiple marker Microarray 179 Correlation with disease-free survival and
immunocytochemical cytology
Wang et al. [15] 2005 CEA RT-PCR 40 The technique of RT-PCR was more sensitive than
conventional PLC in the detection of peritoneal
free cancercells and the prediction of peritoneal
recurrence
Kodera et al. [38] 2005 CK20 RT-PCR 195 Not sufficiently sensitive compared with CEA
Ohashi et al. [35] 2007 CEA TRC method 112 TRC has a diagnostic power almost equivalent to
qRT-PCR but with the advantage of ultra-rapid
detection
Da et al. [57] 2007 Telomerase activity TRAP assay 60 Correlation with high proliferating activity of gastric
cancer
Hiraki et al. [45] 2011 Aberrant gene Metylation-specific PCR 107 Methylation analysis along with a cytological
methylation examination might therefore improve the positive
detection of cancer cells in PF of gastric cancer
Horikawa et al. [62] 2011 CD44, CD45, RT-PCR 147 CD44 mRNA of magnetically separated
EpCAM CD45EpCAM+ cell fraction of PLC is useful for
predicting high-risk individuals among gastric cancer
patients with stage II and III
Takata et al. [41] 2014 CEA, CK20 RT-PCR 104 CEA and CK20 PCR results could predict peritoneal
recurrence after curative surgery
Li et al. [51] 2014 CEA, MMP-7 RT-PCR 116 CEA and MMP-7 transcripts in PLF could effectively
predict peritoneal recurrence
Jeon et al. [43] 2014 CEA, MAGE RT-PCR 117 MAGE expression was determined to be the most
important prognostic factor for recurrence
Tokuhisa et al. [47] 2015 Exosomal miRNAs Agilent Human miRNA 24 miRNA expression profiles can indicate the status of
microarrays and qRT-PCR peritoneum in GC patients
Miwa et al. [49] 2017 FBXO50 The ABI StepOnePlus 200 FBXO50 expression related with recurrence after
Real-Time PCR System curative gastrectomy and shorter overall survival
and TaqMan Copy Number
Assay

CEA: carcino-embryonic antigen; CK20: cytokeratin 20; TRAP assay: telomeric repeat amplification protocol assay; RT-PCR: reverse
transcription polymerase chain reaction; qRT-PCR: quantitative reverse transcription polymerase chain reaction; TRC: transcription
reverse-transcription concerted

presented to be useful for predicting peritoneal metastasis in patients after curative resection for gastric tumor.
The sensitivities of combined CEA and/or CK20 mRNA levels were 86.4% and 81.5%, respectively, clearly
increased compared with that of each marker alone. In the patients with a curative resection, the survival
rate of the PCR-positive was significantly lower than that of PCR-negative in the gastric cancer patients with
a curative surgery. Additionally, the level of CEA or CK20 mRNA was an independent prognostic factor for
overall survival rate . Another prospective study also found that CEA and CK20 RT-PCR results could
[40]
predict peritoneal recurrence after curative surgery .
[41]

Melanoma associated gene
Melanoma associated gene (MAGE) has been said to be a cancer-specific marker responsible for the
[42]
suppression of apoptosis and carcinogenesis . RT-PCR of gastric cancer shows that the MAGE genes are