Elucidating the mechanism of peritoneal dissemination of gastric cancer

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K09076
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Kyoto University
• Principal Investigator: Hisamori Shigeo 京都大学, 医学研究科, 講師 (50534351)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 胃癌 / 腹膜播種

Outline of Final Research Achievements

The results of a prognostic comparison between the P01aCYany group and the P1bcCYany group in 73 patients diagnosed as gastric cancer with peritoneal dissemination (P1 and/or CY1) at our department showed that the 2-year overall survival (OS) rate was 63.6% in the P01aCYany group and 38.9% in the P1bcCYany group, and 5-year OS was 39.0% in the P01aCYany group and 9.9% in the P1bcCYany group, with the P1aCYany group having a significantly better prognosis. Ascites and peritoneal nodules were collected from two patients with positive peritoneal dissemination of gastric cancer, but the cell count was very small and cDNA generation was not possible. The human gastric cancer cell lines NCI-N87 and KATO-III were used to create a mouse peritoneal dissemination model.

Free Research Field

消化管外科

Academic Significance and Societal Importance of the Research Achievements

胃癌腹膜播種の予後は極めて不良である。特に播種が進行し胃癌が腹腔内に遊離した状態(CY1)から腹膜転移(P1)をきたした後は、結節増大による出血や腸閉塞、転移結節壊死による疼痛や発熱、更に腹水貯留・栄養状態悪化など多様な病状を示し、緩和的にも対応困難な経過をたどることが多い。今回臨床データをupdateすることにより、改めて腹膜転移が広がった場合予後が悪くなることを示すことができた。マウスを用いて胃癌腹膜播種の形成過程を分子生物学的に検証中であるが、治療介入可能なメカニズムを同定できれば、胃癌の腹膜播種進行を食い止める一助となると考えている。さらに研究を続けていきたいと考えている。