流式细胞术检测胃癌术中腹腔冲洗液CEA的临床意义

目的探讨检测胃癌患者腹膜微转移的方法。方法收集50例胃癌和9例胃良性病变患者的术中腹腔冲洗液,采用流式细胞学（FCM）方法检测腹腔冲洗液中癌胚抗原（CEA）,采用HE染色进行腹腔冲洗液细胞学检查,并结合临床病理资料进行分析。结果胃癌患者腹腔冲洗液中CEA的检出率为46%（23/50）,明显高于细胞学检查的检出率（20%,10/50）,且阳性率随肿瘤浸润深度、TNM分期、淋巴结转移及浆膜受累程度增加而增加。9例良性病变患者FCM及细胞学检查结果均为阴性。结论流式细胞学方法检测腹腔冲洗液CEA是检测腹腔游离癌细胞和预测腹膜转移的有效方法。

Clinical value of CEA detected by flow cytometry in peritoneal washings from patients with gastric cancer

Objective To explore a method for predicting peritoneal micrometastasis in gastric cancer patients. Methods During operation peritoneal washings of 50 patients with gastric cancer and 9 patients with benign gastric diseases were collected to detect the carcinoembryonic antigen （CEA） using flow eytometry （FCM）. The peritoneal washings cytological examination was carried out by HE staining. And the clinicopathologic data were together analyzed. Results For gastric cancer patients, the detectable rate of CEA in peritoneal washings by FCM was 46% （23/50）, which was significantly higher than that of metastatic cell by cytological examination （20%; 10/50）. The positive rate of CEA concurrently increased with the depth of tumor invasion, TNM staging, lymph node metastasis and serosal involvement. While both the positive rate of CEA by FCM and cytological examination was zero in 9 patients with benign gastric diseases. Conclusion The detection of CEA by FCM serves is effective method for detect intraperito- neal free cancer cells and predict peritoneal metastasis.