【摘要】 目的　比较腹腔冲洗液中CEAmRNA、CEA蛋白和细胞学检测游离癌细胞及预测腹膜转移的应用价值。方法　术中收集 43例胃癌和 10例胃良性病变的腹水或腹腔冲洗液 ,分别采用RT PCR方法测定腹腔液中游离癌细胞CEAmRNA表达 ,放射免疫检测上清液中CEA蛋白含量 (p CEA) ,同时做腹腔冲洗细胞学 (peritoneallavagecytology ,PLC)检查。结果　CEAmRNA表达阳性率 (5 6 .3% )明显高于p CEA (38.1% )或PLC (33.0 % ,P <0 .0 5～ 0 .0 1)。CEAmRNA表达量随侵袭深度、病期进展而增加 (P <0 .0 5 ) ,因大体类型、浆膜类型不同 ,其阳性表达级别差异有显著性 (P <0 .0 5 )。结论　三种方法均适用于胃癌腹腔脱落癌细胞的诊断或腹膜转移的预测 ,但对微量癌细胞检出的灵敏性 ,以RT PCR方法为优。更多还原

【Abstract】 Objective To ascertain the usefulness of CEA determination and cytology of peritoneal washings in the prediction of metastasis of gastric cancer to the peritoneum.Methods CEA was detected at mRNA level by RT PCR and at protein level by radioimmunoassay (RIA). Cytologic examination was done by conventional method. Peritoneal washings were collected during operation from 43 patients with gastric carcinoma and 10 with benign lesions.Results The positive rate of RT PCR was 56.3% and that of RIA was 38.1%. Both were more sensitive than that of cytologic examination (33.1%) of free cancer cells in the peritoneal washings. The level of CEA mRNA expression increased with the depth of invasion and stage of the disease. It also varied significantly in tumors different in the gross type and serosal involvement.Conclusion To detect CEA in peritoneal washings by RT PCR and RIA, and to examine them for tumor cells by cytotogic method are useful to predict subclinical metastasis to the peritoneam in patients with gastric carcinoma, but RT PCR is most sensitive.更多还原