胃癌患者腹腔内游离癌细胞检测及其相关因素与预后

目的:探讨胃癌患者腹腔内游离癌细胞形成的相关因素。方法:对114例胃癌患者在手术中对肿瘤未行侵入性操作前予以腹腔冲洗液细胞学检测,分析腹腔游离癌细胞的产生与浆膜受侵、淋巴结转移、临床分期及病理分型等因素的相关性并对所有患者进行3年的追踪回访。结果:114例胃癌腹腔冲洗液细胞学阳性率为39·47%(45/114),淋巴结转移、临床病理分期、肿瘤病理类型与腹腔冲洗液细胞学阳性显著相关,P<0·01,腹腔游离癌细胞阳性者预示术后不佳。3年内,腹腔游离癌细胞阳性组45例患者无1例生存。结论:腹腔脱落癌细胞形成微转移性,是胃癌术后腹腔复发及转移的主要危险因素之一。肿瘤浸润深度,淋巴结转移及TNM分期与腹腔游离癌细胞呈正相关。术中检测游离癌细胞有助于评价病期、手术效果,并为辅助治疗提供依据。

Correlation and prognosis by examining intraabdominal free cancer cell in gastric carcinoma

OBJECTIVE:To explore the correlative factors of intraabdominal free cancer cell fomation in gastric carcinoma. METHODS: A total of 114 cases of gastric carcinoma being operated by peritoneal washing cytology before invasive operation were analyzed to assess the prognosis of positive cytology results and its relation with serosal invasion, lymphnode metastasis and stage classification both clinic and pathology. All cases were followed up for 3 years. RESULTS: The overall positive rate of cytology was 39.47% (45/114). There was a closely relation between the exfoliation from the tumor and the peritoneal dissemination. Serosal invasion, Lymphnode metastasis, TNM classification had great risk for positive cytology and imply poor prognosis. CONCLUSION: Peritoneal lavage cytology can predict the classification and operative effect, and provide information for further adjuvant therapy.