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目的　研究细胞角蛋白 2 0 (CK2 0 )和癌胚抗原 (CEA)单抗免疫细胞化学 (ICC)染色方法在胃癌病人腹腔冲洗液脱落癌细胞检测中的临床应用价值。方法　应用CK2 0和CEA两种标志物 ,对 30例胃癌病人腹腔冲洗液细胞涂片进行免疫细胞化学染色及常规腹腔冲洗液细胞学检查 (CY) ,检测腹腔内脱落癌细胞。结果　ICC阳性检出率 (43 3%)明显高于CY (2 3 3%) (P <0 0 5 ) ;CK2 0单抗检出 13例ICC阳性病例中的 12例(92 3%) ,优于CEA(76 9%) ;腹腔内癌细胞的脱落与浆膜受侵、胃癌分化程度、有无淋巴结转移相关 (P <0 0 5 ) ,并与临床分期密切相关 (P <0 0 1)。结论　采用CK2 0单抗免疫细胞化学染色方法检测腹腔冲洗液中脱落癌细胞是一种简单有效的方法 ,有临床实用价值。

Detection of exfoliative cancer cells in peritoneal cavity of patients with gastric cancer

Objective To evaluate the value of CK20 and CEA monoclonal antibodies(Mab) for detecting exfoliative gastric cancer cells in peritoneal washes.Methods Peritoneal washes were obtained from 30 patients with gastric carcinoma during laparotomy.The cytologic samples were stained by the conventional HE method and SP immunocytochemical(ICC) method with CK20 and CEA.Results Immunocytochemical detection was superior to conventional lavage cytology with the positive rate 43.3%(13/30) and 23.3%(7/30), respectively.In the two markers,CK20 was more sensitive.Out of 13 positive peritoneal cavity lavages,12(92^3%) of the samples reacted with CK20 Mab and 10(76^9%) with CEA Mab.The rate of positive detection by immunocytochemical assay was significantly correlated with invasion of serosa,the type of histopathology and lymphatic metastasis(P<0.05),and also with PTNM classification (P<0.01).Conclusion Immunocytochemical staining with CK20Mab and CEAMab is a more sensitive and specific method for the detection of microscopically disseminated cancer cells in gastric cancer than conventional cytology.