【摘要】 目的:初步观察癌胚抗原(CEA)逆转录-聚合酶链反应(RT-PCR)检测胃癌腹腔洗液中游离癌细胞的临床价值。方法:收集36例进展期胃癌和6例慢性胆囊结石病人腹腔灌洗液100 ml,其中50 ml行CEA RT-PCR,扩增CEA特异性片断;50 ml行细胞学检查。胃癌细胞株MKN-45为阳性对照。结果:36例胃癌病人腹腔灌洗液中14例于131 p处见CEA的特异性条带,阳性率为38.9％(14/36);6例慢性胆囊结石病人腹腔灌洗液RT-PCR结果均为阴性;MKN-45在131 bp处发现CEA的特异性条带。细胞病理学检查,36例胃癌病人中有6例腹腔灌洗液中发现有肿瘤细胞或核异形细胞,阳性率为16.6％(6/36),且此6例RT-PCR结果均为阳性;8例RT-PCR结果阳性病人的细胞学检查为阴性。CEA RT-PCR的阳性率与肿瘤胃壁浸润深度、淋巴结转移数和胃癌分化程度明显相关。随访至今,36例进展期胃癌病人中CEA RT-PCR检查阴性的病人尚无一例腹腔内肿瘤复发,1例细胞学检查阴性而CEA RT-PCR阳性的病人术后4个月时出现腹腔内肿瘤复发。结论:腹腔灌洗液中胃癌细胞CEA mRNA的RT-PCR检测法敏感性较高,初步临床观察及随访显示该法有望作为诊断腹腔内游离癌细胞的有效辅助手段。更多还原

【Abstract】 Objective: To investigate the clinical value of free gastric canncer calls detected in the peritoneal cavity washes by CEA RT-PCR. Methods: A hundered milliliter of peritoneal lavage was obtained from each of 36 patients with advanced gastric cancer and 6 patients with cholecystolithiasis at the beginning operation. A half of the 100 ml peritoneal washes was used for RT-PCR detection while the other part was used for cytopatholgical examination.Gastric cancer cell line MKN-45 was served as positive control. Results: MKN-45 and peritoneal washes of 14 gastric cancer patients (14/36,38.9%),including all 6 patients with positive cytology results (6/36,16.6%)were proved positive for CEA. None of 6 cholecystolithiaasis patients was positive. Moreover, a close association with the depth of cancer invation,lymph node metastasis and tumor differentiation was established. There is one patient recurred intraperitoneally 4 months after curative surgery with positive RT-PCR and negative cytologic results and no patient recurred with negative RT-PCR up to the present. Conclusions: Detection of free cancer cells in peritoneal washes is more reliable by RT-PCR compared with cytology examination, and is promising as a valuble method for prediction of peritoneal recurrence in gastric cancer.更多还原