1.Detection of intraperitoneal free cancer cells in gastric cancer patients undergoing gastrectomy and its relationship with short-term prognosis
Dafang LIU ; Chao SHEN ; Yushi ZHOU ; Zhiyuan ZHENG ; Xin LIU ; Yingjiang YE ; Qiwei XIE ; Mujun YIN ; Xiaodong YANG ; Kewei JIANG ; Haipeng XIAN ; Xiaotao ZHAO ; Bin LIANG ; Shan WANG
Chinese Journal of General Surgery 2018;33(5):376-380
Objective To evaluate different methods in detecting intraperitontal free cancer cells (IFCCs) in patients with gastric cancer and to clarify the relationship between positive IFCCs and short-term prognosis.Methods A total of 119 gastric cancer patients who underwent surgical treatment were enrolled.Peritoneal lavage was performed with 300-400 ml saline respectively at three points of time:immediately after abdominal cavity entry;when surgical operation was completed;when extensive intraoperative peritoneal lavage was done.The IFCCs were detected with methods of traditional centrifugal cytology,membrane cytology,ICC and RT-PCR.The survival curve of patients with gastric cancer was drawn using Kaplan-Meier method.Results The positive rate of PLC was 16.8%,20.7% and 11.2% respectively at 3 timepoints (P < 0.05).The positive rates of ICC were 28.6%,38.8% and 20.7% respectively at 3 timepoints.The positive rates of RT-PCR were 39.3%,69.5% and 50.8% respectively at 3 time points.The positive rate of IFCCs detected through RT-PCR was higher than that of PLC and ICC (P < 0.05).The short-term prognosis of patients with positive IFCCs was worse than those with negative results detected with any three method at the timg point immediately after opening the abdomen (P < 0.05).At the timg point immediately after removing the tumors,the short-term prognosis of patients with positive IFCCs detected with PLC was worse (P < 0.05).Conclusion The short-term prognosis was poor in patients with positive IFCCs.It is the best time to detect IFCCs before radical resection.Surgical procedures increase the risk of shedding of IFCCs.