胃癌患者骨髓转移癌细胞的检测和临床观察

Detection of micrometastases in the bone marrow ofpatients with gastric cancer

作者自１９９２年１１月至１９９４年６月应用膜上皮抗原（ｅｐｉｔｈｅｌｉａｌｍｅｍｂｒａｎｅａｎｔｉｇｅｎ，ＥＭＡ）单克隆抗体为探针，连续对８８例胃癌患者进行了１１３次骨髓中转移癌细胞的检测。８８例中查出阳性癌细胞者５８例，阳性率为６５．９％。癌细胞阳性率与胃癌分化程度有关，以低分化腺癌和粘液腺癌阳性率较高，分别为６０．９％和９３．９％。胃癌ＴＮＭ分期Ⅰ、Ⅱ、Ⅲ和Ⅳ期阳性率分别为４２．９％、５７．１％、７３．７％和６９．０％。骨髓转移癌细胞与淋巴结转移无明显关系。单纯手术、手术＋化疗以及手术＋化疗＋免疫治疗三组癌细胞转阴率分别为２５．０％、４２．８％和６２．５％。

AbstractAn immunocytochemical method using an antibodyprobe to recognise the epithelial membrane antigen wasused to screen smears obtained surgically from bone-marrow in 88 patients with gastric cancer,Tumor cellswere detected in the bonb-marrow of 58 patients(65.9%).The EMA positive cells in the marrow werenot correlated with the locatiOn and node status of thestomach.In the stage of TNM Ⅰ ,Ⅱ ,Ⅲ and Ⅳ,thepositive rates of micrometastases in the bone marrowwere 42.9%, 57.1%, 73.7%and 69.0%,respective-ly. The results showed that the poorer differentiatedlesion,the higher rate of positive cells in the bonemar-row,The curative surgery and muItimodality treat-ment after operation could result in remission of posi-tive cells in some patients,The method can detect oc-cult metastases in bone marrow, and may be useful tomonitor patients for evidence of response,It can mea-sure the efficacy of adiuvant therapy,and predictprognosis of the patients.