Study on peritoneal micrometastasis by detection of CEA in peritoneal lavage fluit in patients underwent laparoscopy-assisted radical gastrectomy
10.3760/cma.j.issn.1008-6315.2010.07.002
- VernacularTitle:腹腔镜胃癌根治术中腹腔冲洗液癌胚抗原检测探讨腹膜微转移的价值
- Author:
Hongbin LIU
;
Zhenfang LIU
;
Xiaopeng HAN
;
Wankun ZHU
;
Lin SU
- Publication Type:Journal Article
- Keywords:
Gastric cancer;
Carcinoembryonic antigeon;
Laparoscopy;
Radical gastrectomy;
Hyperther mic chemotherapy;
peritoneal lavage cytology examinations;
Flow cytometry
- From:
Clinical Medicine of China
2010;26(7):676-678
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the change of CEA in the peritoneal lavage fluit at pre-,post-laparoscopy-assisted radical gastrectomy, and after hyperthermic perfusion chemotherapy, and to investigate the influence of laparoscopy-assisted radical gastrectomy on drop off of cancer cells, the efficiency of hyperthermic perfusion chemotherapy. To investigate whether CEA in the peritoneal lavage fluit detected by flow cytometry (FCM) is an effective predictor of intraperitoneal free cancer cells and peritoneal metastasis. Methods Peritoneal washings of 40 patients with gastric carcinoma were collected to detect CEA using FCM. The peritoneal lavage cytology examinations ( PLC)were detected by H-E staining. Results Laparoscopic surgery in patients with gastric cancer,before resection of gastric cancer the peritoneal washing CEA positive rate 35. 0% (14/40) ,and after operation, the positive rate was 40. 0% ( 16/40) .which was not significantly higher than that before operation ( P > 0. 05 ). After intraperitoneal hyperthermic perfusion chemotherapy the CEA positive rate was 7. 5% (3/40) ,which was significantly lower than that pre-operation(P<0. 05). Before operation there were 4 cases of positive PLC in the peritoneal lavage fluid, 14 CEA-positive detected by flow cytometry, and there was significant difference ( P < 0. 05 ) . All PLC-positive cases were positive for CEA, whereas 10 PLC-negative cases showed CEA-positive. None of CEA-negative cases showed PLC-positive. Conclusions Laparoscopic radical gastrectomy does not increase the intra-abdominal gastric cancer cell shedding. Intraoperative hyperthermic perfusion chemotherapy is simple and feasible approach with high efficiency.Peritoneal washing CEA detected by flow cytometry is an effective index to predictor for intraperitoneal free cancer cells and prediction of peritoneal metastasis.
