二氧化碳气腹对胃癌腹腔脏器种植转移的影响

Effects of CO2 pneumoperitoneum on the abdominal viscera metastasis and peritoneal implantation of gastric cancer cell line

目的研究腹腔镜胃癌手术时CO2气腹对肿瘤腹膜及脏器转移的影响。方法选用人胃癌细胞（MKN45）悬液1ml（2×10^7／m1）注入裸鼠腹腔内，建立人胃癌细胞裸鼠腹腔种植模型。2周后，实验裸鼠分为2组：CO2气腹组（30只）和开腹组（30只）。7周后，探查肿瘤细胞腹膜种植及各脏器转移情况。结果CO2气腹组有27只致瘤，其中8只发生戳孔种植，19只发生脏器转移；开腹组有26只致瘤，其中7只发生戳孔种植，19只发生脏器转移，两组差异无统计学意义（X^2=0．007，0．240，0．202，0．106，0．042，P〉0．05）。结论CO2气腹没有促进人胃癌细胞裸鼠腹腔脏器转移的发生，腹腔镜胃癌手术具有一定的安全性与可行性。

Objective To study the effects of CO2 pneumoperitoneum on the abdominal viscera metastasis and peritoneal implantation of gastric cancer cell line MKN45 during laparoscopic gastric surgery. Methods The gastric cancer cells metastatic model was established by injecting 1 ml （2 × 10^7/ml）human gastric cancer cell line MKN45 suspension into the caecum wall of 60 Balb/C mice. Two weeks later, the Balb/C mice were divided into CO2 pneumoperitoneum group （ n = 30） and laparotomy group （ n = 30）. All mice were sacrificed 7 weeks later to investigate the abdominal viscera metastasis and peritoneal implantation of gastric cancer cells. Results Twenty-seven rats in CO2 pneumoperitoneum group were induced with tumor, including 8 with trocar port implantation and 19 with organ metastasis; 26 rats in laparotomy group were induced with tumor, including 7 with tracar port implantation and 19 with abdominal viscera metastasis, and the differences between the two groups had no statistical significance （X^2 =0.007, 0.240, 0.202, 0. 106, 0.042, P 〉0.05）. Conclusions CO2 pneumoperitoneum does not stimulate the metastasis of gastric cancer cells to peritoneum and abdominal viscera in Balb/C mice. Laparoscopic surgery for gastric cancer is safe and feasible.