胃癌术中腹腔冲洗液Cox-2 mRNA及CEA mRNA检测临床意义的探讨

Clinical significance of detection of Cox-2 mRNA and CEA mRNA in abdominal lavage of patients with gastric cancer

目的:探讨腹腔冲洗液Cox-2mRNA及CEA mRNA检测的可行性和临床意义。方法:前瞻性比较胃癌腹腔冲洗液RT-PCR法与常规细胞学法(PLC)检出脱落癌细胞的阳性率。结果:32例胃癌患者腹腔冲洗液中Cox-2mRNA及CEA mRNA检出阳性率分别为53.1%(17/32)及56.3%(18/32),明显高于PLC检出癌细胞阳性率(21.9%),χ2分别为5.497及4.433,P<0.05。17例RT-PCR法检出阳性病例中,Cox-2mRNA法检出16例(94.1%),CEA mRNA法检出15例(88.2%),两种基因腹腔冲洗液脱落癌细胞检测阳性率大致相同,且检测阳性率与浆膜浸润阳性、浆膜浸润面积大、病理组织学类型、淋巴结转移和TNM病期呈正相关。结论:RT-PCR法检测胃癌腹腔冲洗液Cox-2mRNA与CEA mRNA表达,可显著提高脱落癌细胞的检测阳性率,具有广泛的临床应用价值和意义。

OBJECTIVE： To investigate the feasibility and clinical significance of detection of Cox-2 mRNA and CEA mRNA in abdominal lavage of patients with gastric cancer. METHODS： Comparison of positive rates between detected by RT-PCR technique and peritoneal lavage cytology （PLC） was prospectively performed. RESULTS： The positive rates of Cox-2 mRNA and CEA mRNA of abdominal lavage in 32 patients with gastric cancer, which detected by RT-PCR technique, were 53.1%（17/32） and 6.3% （18/32）, respectively, and they were significantly higher than that （21.9%, 7/32） detected by PLC method （Х^2 were 5. 497 and 4. 433, P〈0.05）. Among the 17 patients of gastric cancer with RT-PCR detection positive of free cancer cells, the positive rats of Cox-2 mRNA and CEA mRNA were 94.1（16/17） and 88.2 %（15/17）, respectively, which suggested that detection of Cox- 2 mRNA and CEA mRNA by RT-PCR technique had similar results. In addition, RT-PCR detection positive rate of free cancer cells by Cox-2 mRNA and CEA mRNA was correlated with serosal involvement, large area of serosal involvement, pathohistological type, lymph node metastasis, and TNM staging. CONCLUSION： Compared with PLC method, detection of Cox-2 mRNA and CEA mRNA of abdominal lavage of gastric cancer patients by RT-PCR technique may significantly improve the detection and have wide clinical application and significance.