CK19和CK20在胃癌患者横结肠系膜前叶中的表达及临床意义

Expression and clinical significance of CK19 and CK20 in the anterior lobe of transverse mesocolon of gastric cancer patients

目的:研究细胞角蛋白(cytokeratin,CK)19、CK20对胃癌腹膜微转移的检测价值,并探讨与微转移发生有关的因素。方法:2007年6月—2007年10月期间30例行手术治疗的胃癌患者,术中行横结肠系膜前叶活组织检查,免疫组织化学法检测CK19及CK20的表达,并行HE染色,以腹腔灌洗检查癌细胞作比较。结果:CK19及CK20在胃癌患者横结肠系膜前叶中的表达阳性率分别为43.3%和30.0%,明显高于腹腔灌洗液细胞学检查法(10.0%),且阳性率因肿瘤侵出浆膜层而升高。结论:术中行活组织检查检测CK19、CK20,可用于判断胃癌患者有无腹膜微转移,从而指导临床分期,为判断预后及建立个体化的术后治疗方案提供更可靠的依据。

Objective： To investigate the role of CK19 and CK20 in determining the peritoneum micrometastasis in gastric carcinoma, and the factors about the occurrence of peritoneum micrometastasis. Methods： Thirty cases of gastric cancer were collected from June to October, 2007. The anterior lobe of transverse mesocolon biopsy was undertaken intraoperatively, CK19、CK20 immunohistochemical staining were performed on the tissue from biopsy, compared with HE staining and peritoneal lavage cytology （PLC）. Results： The positive rates of CK19 and CK20 in the anterior lobe of transverse mesocolon were 43.3% and 30.0% respectively, which were obviously higher than PLC（10.0%）. The positive rate was increased with the depth of tumor invasion. Conclusion： Detecting CK19 and CK20 can be used to conclude the occurrence of peritoneum micrometastasis, accordingly, to accurately determine the clinical staging of patients suffering from gastric carcinoma. It can provide more reliable evidence in postoperative treatment and prognosis.