腹腔冲洗液CEAmRNA检测对胃癌微转移的临床评估及意义.docVIP

腹腔冲洗液CEA mRNA检测对胃癌微转移的临床评估及意义 　　作者：安杰　刘伟　耿建英　刘艳丽　张文　李慧 作者单位：050082　河北石家庄，中国人民解放军白求恩国际和平医院病理科，普外肝胆科 　　【摘要】 目的：评估腹腔冲洗细胞学检查和CEA mRNA检测对胃癌预后的临床意义。方法：收集胃癌及对照（胃良性疾病）组患者的腹腔冲洗液标本，进行腹水细胞病理学和CEA巢式RT-PCR检测，并评价其与临床病理参数的关系。结果：腹水肿瘤细胞检测阳性率为30.3%，CEA巢式RT-PCR检测阳性率为48.5%，其结果与肿瘤分化程度、浸润深度、淋巴结转移和TNM分期有关（P0.05），而与肿瘤的大小无关（P0.05）。对照组腹水肿瘤细胞和CEA检测阳性率均为0。结论：胃癌患者腹腔冲洗液CEA mRNA检测可作为判断胃癌侵袭转移、术后复发情况及患者预后的参考指标之一。 　　【关键词】 胃肿瘤·癌胚抗原·腹水·病理学，临床 　　Clinical assessment and significance of CEA mRNA expression in peritoneal lavage for gastric cancer micrometastasis 　　AN Jie, LIU Wei, GENG Jian-ying, LIU Yan-li, ZHANG Wen, LI Hui 　　Department of Pathology, Department of Hepatobiliary, Bethune International Peace Hospital, Chinese Peoples Liberation Army 　　Shijiazhuang 050082, China 　　【ABSTRACT】 Objective: To evaluate the significance of peritoneal lavage cytology and CEA mRNA detection for clinical assessment of prognosis of gastric cancer. Methods: Peritoneal irrigating solution samples in 66 patients with gastric cancer and 12 innocent ones were collected, peritoneal lavage cytology and CEA mRNA nest-RT-PCR detection were used to exam the exfoliated cancer cells, meanwhile relationships between positive results and relative clinico-pathological parameters were evaluated. Results: The positive rate of HE was 30.3%, and that of nest-RT-PCR was 48.5%. When the degree of histologic differentiation of gastric cancer became poorer, deeply invasion increased, stage of TNM upgraded and lymph node metastasis appeared, positive rate in peritoneal lavage increased significantly （P0.05）. But it was not related to the size of the tumor（P0.05）. Conclusion: The methods may act as the standard for judging the invasive and metastatic state of gastric cancer and forecasting the prognosis of patients with such disease. 　　【KEY WORDS】 Stomach neoplasm·Carcinoembryonic antigen·Ascites·Pathology，clinic 　　 　　腹膜种植转移是影响胃癌患者预后的主要原因之一。胃癌患者就诊时多已处于浆膜受侵的进展期，半数以上患者最终死于腹膜种植转移［1］。因此，及时发现腹膜微转移并予