胰蛋白酶细胞消化液网膜囊冲洗可提高胃癌腹腔亚临床转移诊断的敏感性.docVIP

胰蛋白酶细胞消化液网膜囊冲洗可提高胃癌腹腔亚临床转移诊断的敏感性 庞再林1，白 鍊1，温泽霖1，赵 鹏1，李启刚1，简 斌1，李中福1，杨 强1，吴 帅1，谢 建1，廖 娟2，钟正福3 （402160 重庆医科大学附属永川医院：普外科1，中心实验室2，病理科3） [摘要] 目的 探索提高胃癌腹腔网膜囊亚临床转移诊断的新方式。方法 选取我院2012年1月至2013年10月胃癌手术患者58例，采取简单随机分组为A、B两组。A组35例应用0.25%胰蛋白酶细胞消化液消化、冲洗胃网膜囊囊壁组织，B组23例采取生理盐水冲洗网膜囊囊壁组织。采取免疫组织化学法与HE染色法检测58例胃癌患者网膜囊冲洗液中癌细胞及CEA、CK7、CK20和HPA的表达。结果 A组患者HE染色阳性16例，阳性率45.71%，免疫组化染色阳性29例，阳性率82.86%。B组患者HE染色阳性4例，阳性率17.39%。免疫组化染色阳性11例，阳性率47.83%。两组数据间差异具有统计学意义(P=0.005)。胰蛋白酶消化冲洗液肿瘤标志物相关分析中，CEA阳性表达与HPA阳性表达呈正相关(r=0.488,P=0.003)，CEA阳性表达与CK7阳性表达呈正相关(r=0.389, P =0.021)，CEA阳性表达与CK20阳性表达无相关(r=0.299, P =0.081)，CK7、CK20及HPA三者阳性表达呈正相关(P＜0.05)。结论 胰蛋白酶细胞消化液网膜囊冲洗可提高胃癌腹腔亚临床转移的诊断，免疫组化联合检测CEA、CK7、CK20及HPA，较单个肿瘤标志物检测胃癌腹腔网膜囊亚临床转移敏感性高，为判断预后和术后个体化治疗提供依据。 [关键词] 胃癌；网膜囊转移；胰蛋白酶细胞消化液；免疫组织化学染色 [中图法分类号] [文献标志码] A Omental Bursa Washing by Digestion of Trypsin for Gastric Carcinoma could Improve the Sensitivity of Diagnosis for Subclinical Peritoneal Metastasis Pang Zailin1,Bai Lian1,Wen Zelin1,Zhao Peng1,Li Qigang1,Jian Bin1,Li Zhongfu1,Yang Qiang1,Wu Shuai1,Xie Jian1,Liao Juan2,Zhong Zhengfu3 (402160 Affiliated Yongchuan Hospital of Chongqing Medical University: Department of General Surgery1, Department of Central Laboratory2, Department of Pathology3) [Abstract] Objective To explore the diagnosis new method for omental bursa metastasis of gastric carcinoma.Methods select 58 patients with gastric carcinoma in our hospital from january 2012 to october 2013,divide into two groups for A and B by simple random method.The group A was 35 patients,take the omental bursa digestion and wash by 0.25% trypsin-EDTA solution.The group B was 23 patients,take the omental bursa wash by normal saline.Detect the expression of CEA,CK7,CK20 and HPA in the washing precipitation from 58 patients with gastric carcinoma by the immunohistochemical method and Hematoxylin-Eosin staining.Results In group A,the positive of HE staining was 16 cases(the positive rate was 45.71%).the positive of