Cytologic assessment of peritoneal fluid is important in assessing the spread of tumor during surgical resection for ovarian and colorectal cancer. Studies report that positive results for IHC or RT-PCR testing of peritoneal fluid are an independent prognostic factor, correlating with disease progression.4,56 Assessment of other body fluids by mole cular methods may become useful in assessing the spread of tumors, as has been reported for pleural effusions from patients with lung cancer.57
Some types of fluid samples can be obtained noninva-sively and thus present attractive approaches to screening and early diagnosis of certain cancers. Exfoliated cells are present in the sputum of lung cancer patients.58 Other fluids, such as pancreatic fluid and breast ductal lavage samples may become valuable diagnostic samples.12 However, RNA stability and the presence of adequate numbers of cells in the sample will be considerations for test development and validation. DNA alterations, if present, may be a more reliable marker for tumor cell detection.
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