腹腔镜检查结合RT-PCR在胃癌诊疗中的临床意义  

The clinical significance of laparoscopy combined with RT-PCR in gastric carcinoma diagnosis and therapy

作　　者：张茂修[1] 刘杨[1] 孙善会[1] 汪运山[1] 

机构地区：[1]山东大学临床医学院济南市中心医院,山东济南250013

出　　处：《腹腔镜外科杂志》2007年第6期477-479,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨进展期胃癌术前腹腔镜检查与RT—PCR检测腹腔灌洗液中游离癌细胞CEAmRNA的表达水平，在胃癌患者术后微转移及预后的临床意义。方法：对22例进展期胃癌患者术前行腹腔镜探查，灭菌生理盐水冲洗腹腔4～5次，收集脱落细胞．进行细胞学检查和RT—PCR检测CEAmRNA表达水平。结果：22例胃癌患者中，细胞形态学捡测31．8％（7／22）阳性，RT—PCR捡测54．5％（12／22）CEAmRNA阳性表达，二者阳性率有显著性差异（P〈0．05）。结论：诊断性腹腔镜检查、RT—PCR与PLC有效结合，可提高腹腔转移复发诊断的灵敏性和特异性，有助于对胃癌分期、淋巴转移和预后的综合判断，对胃癌的辅助治疗提供依据。Objective ： To explore the clinical value of preoperative laparoseopy of progressive gastric cancer combined with RTPCR monitoring of CEA mRNA expression of peritoneal lavage fluid（PLF） in micrometastasis and prognosis of postoperative patients with gastric cancer. Methods：Before operation,we examinated 22 patients with progressive gastric cancer by laparoscopy,washing abdominal cavity with 0.9% NS about 4 to 5 times,and collected peritoneal free cells detected by cytology and RT-PCR analysis. Results： The overall positive rate of cytology was 31.8% （7/22）, RT-PCR positive rate was 54.5% （ 12/22）, which was significantly higher than cytology findings（ P 〈 0.05 ）. Conclusions：The efficient association of diagnostic laparoscopy, RT-PCR and PLC （peritoneal lavage cytology） can improve diagnostic specialty and sensitivity of peritoneal metastasis. It is conducive to comprehensive evaluation of gastric cancer staging, lymphnode metastasis and prognosis, which will provide evidence for adjuvant therapy of gastric cancer.

关 键 词：腹腔镜检查 胃肿瘤 游离癌细胞 RT—PCR 

分 类 号：R735.2[医药卫生—肿瘤]