Patients with peritoneal metastasis of gastric cancer in early stage do not have special clinical manifestations and it is difficult to diagnose; while in late stage, it is easier to diagnose when patients have complications such as intestinal obstruction, ascites, masses and malignant fluid, and at this time, patients’ quality of life has been seriously reduced, treatment is difficult and prognosis is extremely poor.
Therefore, timely and accurate diagnosis of peritoneal metastasis of gastric cancer is the key to accurate staging and timely detection of tumor metastasis in follow-up. One of the common methods to detect peritoneal metastasis of gastric cancer is to find cancer cells in the abdominal cavity. Tumor cells shed in the peritoneal cavity are the prerequisite for the formation of peritoneal tumor metastasis. The gold standard for diagnosing peritoneal metastasis of gastric cancer is to find shed tumor cells in the peritoneal cavity, while malignant ascites is a late manifestation of peritoneal metastasis.
After the formation of malignant ascites, the positive rate of ascites exfoliative cytology examination is not high, which may be due to too few tumor cells, tissue variation and morphological atypical hyperplasia, in addition to other factors including the timeliness of specimen delivery, sampling method, smear thickness, fixation and staining quality.
In addition, there are other influencing factors including the timeliness of specimen delivery, sampling method, smear thickness, fixation, staining quality and the experience of the examiner, so a negative result of ascites exfoliative cytology does not negate the malignancy of the fluid. Traditional cytology of peritoneal washings can be an important tool for diagnosis and prediction of tumor peritoneal metastasis and recurrence.
However, its sensitivity of detecting microscopic tumor cells is poor, and the number of cells in each smear is limited, which has a high leakage rate, and the cells in the peritoneal washings often have more obvious degeneration, which increases the difficulty of diagnosis.
If tumor cells can be found by the above methods, the diagnosis of tumor peritoneal metastasis can be made clearly, but these methods cannot localize the primary foci of tumor. Because of the difficulty and low sensitivity of peritoneal metastasis diagnosis by cytological examination of peritoneal washings, and because it is usually performed during surgery, it is not routinely used in clinical practice. The main treatment method to detect peritoneal metastasis of gastric cancer is body cavity tumor control technique. Director Deng Yunzong of the Department of Oncology of the Third Affiliated Hospital of Henan College of Traditional Chinese Medicine, supported by high-precision peritoneal thermal perfusion chemotherapy technology, proposed and implemented the tumor body cavity control technology for a long time, organically integrating the advantages of Chinese medicine characteristic therapy – Yangzheng and water-dispersal method and Chinese and Western medicine combined with internal medicine treatment to form a comprehensive treatment plan for cancerous thoracoabdominal fluid with outstanding efficacy, which greatly reduces patients’ pain, improves patients’ quality of life and prolongs survival time;