【摘要】 目的 探讨胃癌患者腹腔冲洗液中游离癌细胞的检测及其临床意义。方法 用扩增CEAmRNA的巢式RT-PCR方法检测42例胃癌患者胃切除手术前后腹腔冲洗液中游离癌细胞。结果 (1)胃癌组织中CEAmRNA表达均阳性，而非癌患者腹腔冲洗液、间皮细胞及健康人血细胞样本中CEAmRNA表达均阴性;(2)用胃癌细胞梯度稀释标本进行巢式RT-PCR检测CEAmRNA，发现其检测敏感性达到1/10 5 ，(3)42例胃癌患者中，胃切除手术前后分别有16例(38.1%)和19例(45.2%)患者腹腔冲洗液中游离癌细胞阳性;(4)胃切除手术前腹腔冲洗液中游离癌细胞阳性与肿瘤浸润深度、TNM分期密切相关(P<0.05)。结论 (1)扩增CEAmRNA的巢式RT-PCR方法是检测胃癌患者腹腔冲洗液中游离癌细胞的敏感而特异的方法;(2)检测胃癌患者腹腔内游离癌细胞有助于判断肿瘤进展程度;(3)手术操作可能促进癌细胞的腹腔内播散。

    Xia Jiazeng，Li Jianping，Zhou Hong，et al.

    Department of General Surgery，Wuxi Second People’s Hospital，Jiangsu214002.

    【Abstract】 Objective To study the detection of free cancer cells in abdominal washings of patients with gastic carcinomas and its clinical significance.Methods Pre-and post-operative abdominal washings in42cases of patients with gastric carcinomas were detected for free cancer cells by nested RT-PCR amplification for CEAmRNA.Results (1)CEAmRNA was expressed in all gastric cancer tissues but not in abdominal washings of noncancer patients or in mesothelial cells and peripheral blood of healthy individuals;(2)Sensitivity of nested RT-PCR amplification for CEAmˉRNA was confirmed to be1/10 5 by serial dilusion method using human gastric cancer cell;(3)In42patients with gastric carcinomas ......