腹腔热灌注化疗对Ⅲ期胃癌腹腔游离癌细胞的杀灭作用及其对预后的影响  

Effect of hyperthermic intraperitoneal chemotherapy on intraperitoneal free cancer cells in patients with stage Ⅲ gastric cancer and its effect on the prognosis

作　　者：孙建华 陈元杏 张碧涛 黄国全 吴泉峰 

机构地区：[1]恩施土家族苗族自治州中心医院胃肠外科,湖北445000

出　　处：《中华实验外科杂志》2016年第4期1100-1102,共3页Chinese Journal of Experimental Surgery

基　　金：恩施州科技计划研究与开发项目（D2014007）

摘　　要：目的 观察术中腹腔热灌注化疗（HIPEC）对Ⅲ期胃癌腹腔游离癌细胞（IFCCs）的杀灭作用及其对预后的影响.方法 40例Ⅲ期胃癌患者接受了胃癌根治术及术中腹腔热灌注化疗,收集热灌注化疗前腹腔灌洗液标本,分别采用脱落细胞学检测、肿瘤标志物检测、反转录-聚合酶链反应（RT-PCR）检测癌胚抗原（CEA） mRNA、角蛋白20（CK20） mRNA等3种方法检测腹腔游离癌细胞,随访患者预后,研究上述检测结果与预后的关系.结果 脱落细胞学、腹水肿瘤标志物、RT-PCR检测IFCCs的阳性率分别为40.0％、52.5％和62.5％.40例患者总生存期为48.3个月[95％可信区间（CI）：33.6 ～ 63.0个月],1、3、5年生存率分别为100.0％、63.4％、30.4％.脱落细胞学检测、肿瘤标志物检测、RT-PCR检测腹腔游离癌细胞阳性、阴性患者总生存期差异均无统计学意义（P＞0.05）.结论 HIPEC可通过作用于IFCCs,延长Ⅲ期胃癌患者生存期.Objective To evaluate the effect of hyperthermic intraperitoneal chemotherapy （HIPEC） on the intraperitoneal free cancer cells （IFCCs） in patients with stage Ⅲ gastric cancer and its effect on the prognosis.Methods Forty patients with stage Ⅲ gastric cancer underwent radical operation and intraoperative hyperthermic intraperitoneal chemotherapy.The peritoneal lavage liquid from these patients was collected before HIPEC.The intraperitoneal free cancer cells from peritoneal lavage liquid were detected using cytology test,tumor makers test and real time reverse transcript polymerase chain reaction （RT-PCR） detecting carcinoembryonic antigen （CEA） mRNA and cytokeratin-20 （CK20） mRNA,respectively.The relationship between the results of IFCCs and the prognosis was evaluated.Results The positive rate of intraperitoneal free cancer cells detected by peritoneal lavage cytology test,tumor makers test and RT-PCR test was 40.0%,52.5% and 62.5%,respectively.The overall survival of the 40 patients was 48.3 months [95% confidence interval （CI） 33.6-63.0 months],and the 1-,3-,and 5-year survival rate was 100.0%,63.4% and 30.4%,respectively.The IFCCs test results showed no significant effect on the overall survival.Conclusion HIPEC could prolong survival of stage Ⅲ gastric cancer patients by effectively eradicating IFCCs.

关 键 词：胃癌 腹腔热灌注化疗 预后 

分 类 号：R735.2[医药卫生—肿瘤]