Background: Gastric cancer is one of the main tumors in actuality, being the 4th most
common in the world. The treatments for such disease vary according to classification and
degree of disease. Peritoneal metastasis, which is peritoneal cavity dissemination of free
tumor cells, can often occur. The diagnosis and treatment of this degree of adenocarcinoma is
still being discussed in order to find more reproducible and reliable methods. This paper
analyzes flow cytometry as an alternative for diagnostics and extensive peritoneal lavage as
treatment. Methods: A counting of free tumor cells via flow cytometry was made in each
moment of the gastrectomy in the 3 steps of peritoneal lavage, which are the following: 1 liter
of physiological saline was used at the moment of opening of the abdominal cavity (1st
lavage); 1 liter right after resection of the tumor (2nd lavage) and 9 liters after changing sterile
gloves (3rd lavage). In each step, 20 mL were withdrawn from the lavage and analyzed
through flow cytometry, with staining of fluorochromes CD326 and CD45 and then the
Tumor Cells/Leukocytes Ratio - TLR was calculated. Results: An intermediate TLR was
obtained in the 1st lavage, a higher TLR on the 2nd and a lower TLR on the 3rd, with
statistically significant difference between groups. Non parametric tests were used for
statistical analysis (Kruskall-Wallis test and Student-Newman-Keuls comparison test).
Conclusion: We have concluded that: 1 - there were metastatic precursors in the peritoneal
cavity before tissue mobilization in all patients; 2 - after the tumor resection surgery, there
was an expressively larger number of metastatic precursors in the cavity; 3 - with extensive
peritoneal lavage there was a smaller quantity of free tumor cells compared to before the
surgical procedure, promoting an expressive decrease on the registers of such cell lineage
comparing to the 2nd lavage, possibly contributing to reduced chances of peritoneal
metastization and a better quality of life and clinical outcomes.
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