腹腔液中层粘连蛋白含量与胃癌病理及腹膜转移相关因素的关系

目的探讨胃癌腹腔液中层粘连蛋白含量与其病理生物学行为及腹膜转移相关因素的关系.方法术中收集50例胃癌和10例胃良性病变的腹水或腹腔冲洗液,采用放射免疫技术检测上清液中层粘连蛋白、CEA蛋白(p-CEA)含量,同时进行腹腔冲洗细胞学(peritoneal lavage cytology,PLC)和病理学检查.结果层粘连蛋白含量与胃癌组织学类型、生长方式、浸润深度及淋巴结转移呈正相关.PLC和p-CEA阳性组层粘连蛋白含量均高于阴性(P＜0.05);肉眼腹膜转移的10例中层粘连蛋白均显著升高.全组层粘连蛋白含量升高者占68%,明显高于p-CEA(44%)和PLC(34%)的阳性率.结论腹腔液中的层粘连蛋白是反映胃癌生物学行为的分子标志物,与胃癌腹膜转移密切相关,其预测腹膜亚临床转移的灵敏性优于p-CEA和PLC.

Laminin concentration of peritoneal washings in gastric cancer and its relationship to pathological factors and peritoneal metastasis

Objective: To determine the peritoneal laminin concentration in gastric cancer and its relationship to pathological factors and peritoneal metastasis. Methods: Peritoneal washings were collected during operation from 50 patients with gastric carcinoma and 10 with benign lesions. The concentration of laminin was measured radioimmunologically. Peritoneal cytological examination (PLC) and measurement of carcinoembryonic antigen (p-CEA) levels were also performed. Results: The concentration of laminin was positively correlated with the depth of cancer invasion, as well as the growth pattern and lymphatic metastasis. Patients with a positive PLC and p-CEA had significantly higher laminin concentration than those with a negative result (P <0.05). Of the 10 patients with clinically evident peritoneal metastasis, 9 cases had elevated laminin level. The elevated rate of laminin was 64%, which was more sensitive than the positive rates of p-CEA (44%) and PLC (34%). Conclusions: The level of peritoneal laminin is a molecular marker of biological behavior of gastric cancer and provides evidence of peritoneal metastasis. Quantitative detection of peritoneal laminin concentration may be useful in prediction of subclinical metastasis to peritonium in patients with gastric cancer.