端粒酶活性和细胞学检测胃癌腹腔液中游离癌细胞的初步评价

目的比较腹腔灌洗液中端粒酶活性和细胞学检测游离癌细胞及预测腹膜转移的应用价值.方法应用端粒重复扩增(TRAP)-酶联免疫吸附测定(ELASA)法检测52例胃癌和12例胃溃疡患者腹腔灌洗液中的端粒酶活性,同时对52例胃癌患者行腹腔灌洗液脱落细胞学(peritoneallavage cytology,PLC)检测.结果12例胃溃疡患者腹腔灌洗液中端粒酶活性均为阴性.胃癌患者腹腔灌洗液中端粒酶活性的阳性率随侵袭深度、病期进展而增加(P＜0.05).TRAP-ELISA方法的阳性率比脱落细胞学检测显著增高(48.1%比25.0%,P＜0.05).结论两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度,以端粒酶活性检测为优.

The value of telomerase activity and cytology of peritoneal washings in the prediction of metastasis of gastric cancer

Objective To compare the usefulness of telomerase activity and cytology of peritoneal washings in the prediction of metastasis gastric cancer to the peritoneum Methods Telomeric repeated amplification protocol(TRAP) enzyme linked immunosorbent assay (ELISA) was performed on peritoneal washings collected from 52 patients with gastric cacinoma and 12 patients with gastric ulcer Exfoliate cytologic analysis was used for comparison Results No telomerase activity was found in 12 gastric ulcer patients peritoneal washings The positive rates of telomerase activity in peritoneal washing collected from patients with gastric carcinoma increased with the depth of invasion and stage of the disease ( P <0 05) The positivity rate of TRAP-ELISA was significantly higher than that of exfoliative cytology (48 1% vs 25 0%, P <0 05) Conclusion To detect telomerase activity in peritoneal washings and to examine it for tumor cells by cytologic method are useful to predict subclinical metastasis to the peritoneum in patients with gastric carcinoma, but telomerase activity is the most sensitive.