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Effectiveness of circulating tumor cells and circulating tumor DNA in peritoneal lavage fluid for predicting metachronous peritoneal metastasis of gastric cancer

  • 0Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, Adress:160 Pujian Road, Pudong New Area, Shanghai, China.
Translational Research : the Journal of Laboratory and Clinical Medicine +

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August 28, 2025

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August 28, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Detecting circulating tumor DNA (ctDNA) and circulating tumor cells (CTC) in peritoneal lavage fluid (PLF) can identify gastric cancer patients at high risk for peritoneal metastasis. Postoperative analysis of ctDNA and CTC in PLF offers the highest accuracy for risk stratification.

Area Of Science

  • Oncology
  • Gastroenterology
  • Molecular Diagnostics

Background

  • Peritoneal metastasis is a major cause of mortality in gastric cancer (GC).
  • Early diagnosis and identification of high-risk GC populations are crucial.
  • The role of circulating tumor DNA (ctDNA) and circulating tumor cells (CTC) in peritoneal lavage fluid (PLF) is unexplored.

Purpose Of The Study

  • To investigate the utility of ctDNA and CTC in PLF for predicting peritoneal metastasis in GC patients.
  • To evaluate the diagnostic and prognostic performance of ctDNA and CTC in PLF.

Main Methods

  • Stage III GC patients were enrolled, with preoperative and postoperative PLF collection.
  • ctDNA in PLF supernatant was analyzed using next-generation sequencing (NGS).
  • CTC in PLF pellet were detected via immunofluorescence (EpCAM, FR, CK).

Main Results

  • ctDNA-positive and CTC-positive patients exhibited significantly higher risks of peritoneal metastasis.
  • Postoperative ctDNA demonstrated superior predictive efficacy for peritoneal metastasis (AUC 0.93) compared to preoperative ctDNA (AUC 0.86).
  • Combined ctDNA/CTC positivity in postoperative PLF identified the highest recurrence risk.

Conclusions

  • Postoperative ctDNA and CTC detection in PLF achieved 85% accuracy in predicting peritoneal metastasis.
  • This combined approach enables effective risk stratification for GC patients.
  • The findings may guide postoperative prophylactic intraperitoneal chemotherapy decisions.

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