胃癌术中腹腔灌洗液的CEA^(··)mRNA的检测及意义  

Detection of CEA^(··)mRNA in peritoneal washings of gastric cancer and its clinical significance

作　　者：张岩松[1] 罗光华[2] 许军[1] 朱江[2] 王荣朝[1] 董选[2] 张晓膺[3] 徐宁 

机构地区：[1]苏州大学附属第三人民医院胃肠外科,江苏常州213003 [2]苏州大学附属第三人民医院综合实验室,江苏常州213003 [3]苏州大学附属第三人民医院心胸外科,江苏常州213003 [4]瑞典LUND大学医学院临床化学研究所,lund瑞典21185

出　　处：《中国普通外科杂志》2004年第9期664-666,共3页China Journal of General Surgery

摘　　要：目的　探索建立一种较敏感的检测胃癌手术时腹腔灌洗液中游离癌细胞的方法。方法　应用实时荧光逆转录 -多聚酶链反应 (RT PCR )方法定量检测 65例胃癌术中腹腔灌洗液的CEA mRNA ,同时用腹腔冲洗细胞学方法 (PLC )涂片寻找癌细胞。设 5例良性胃疾病的术中腹腔灌洗液及5例健康志愿者血液为阴性对照。结果　 (1)良性胃病组和对照组CEA mRNA均为阴性 ;(2 )胃癌组中RT -PCR方法检测游离癌细胞的阳性率为 47.7% ,无假阳性 ;而PLC的检出率仅为 12 .3 %。胃癌组中CEA mRNA阳性率与肿瘤浸润深度、病理分期 (I +II和III +IV期 )、有无腹膜转移均有明显相关性 (均P 0 .0 5 )。结论　实时荧光RT PCR较PLC方法检测胃癌患者腹腔灌洗液中的游离癌细胞具有更高的敏感性及特异性 ;游离癌细胞的存在和肿瘤临床病理因素有一定的相关性。Objective To establish a more sensitive method to detect free cancer cells in peritoneal washings of gastric cancer cases during surgery. Methods The CEAmRNA levels in peritoneal washings in 65 cases of gastric cancer were detected by Real-time RT-PCR. PLC was applied simultaneously to detect free cancer cells. Negative controls included the peritoneal washings from 5 cases of benign gastric diseases and the blood samples from 5 cases of healthy adult volunteers. Results (1)CEAmRNA was not found in peritoneal washings in benign gastric diseases and in blood of healthy adult volunteers. (2)The positive percentage of free cancer cells detected by Real-time RT-PCR was 47.7%, while PLC′s was only 12.3%.(3)The positive rate of CEAmRNA showed a significant difference between gastric cancer with serosal invasion and without serosa invasion groups, between peritoneal metastasis group and no peritoneal metastasis groups, and also between stages I+II and III+IV diseases(all P<0.05). Conclusions Real-time RT-PCR is a sensitive, specific method to detect free cancer cells in peritoneal washings, and appearance of free cancer cells in peritoneal washings is related to the clinical stage and pathologic type of gastric cancer.

关 键 词：胃肿瘤/诊断 腹腔灌洗液 CEA MRNA 

分 类 号：R735.2[医药卫生—肿瘤] R459.5[医药卫生—临床医学]