Tumour Markers in Peritoneal Washing Fluid - Contribution to Cytology


Background: Peritoneal washing cytology (PWC) that shows the microscopic intra-peritoneal spread ofgynaecologic cancers is not used in staging but is known as prognostic factor and effective in planning theintensity of the therapy. False negative or false positive results clearly affect the ability to make the best decisionfor therapy. In this study we assessed levels of tumour markers, carcinoembryonic antigen (CEA), cancerantigen 125 (CA-125) and carbohydrate antigen (CA19-9), in peritoneal washing fluid to establish any possiblecontribution to the peritoneal washing cytology in patients operated for gynaecologic cancer. Materials and
Methods: Preoperative tumour markers were studied in serum of blood samples obtained from the patientsfor preoperative evaluation of a gynaecologic operation. In the same group peritoneal tumour markers werestudied in the washing fluid obtained for intraoperative cytological evaluation.
Results: This study includeda total of 94 patients, 62 with malignant and 32 with benign histopathology. The sensitivity of the cytologicalexamination was found to be 21% with a specificity of 100%. When evaluated with CEA the sensitivity of thecytological examination has increased to 37%.
Conclusions: In addition to examination of PWC, the level ofCEA, a tumour marker, in peritoneal washing fluid can make a diagnostic contribution. Determining the levelof CEA in peritoneal washing fluid will be useful in the management of gynaecologic cancers.