肝癌术中腹腔内游离癌细胞与术后种植转移的相关性分析

Analysis of the correlation between the number of scattering tumor cells in peritoneal cavity during operation with liver cancer and the incidence of the postoperative seeding metastasis

目的分析肝癌术中腹腔内游离癌细胞数量与术后种植转移发生率的相关性,为肝癌术后种植转移的早期诊断、预测和预防奠定理论基础。方法收集128例原发性肝癌患者术中的腹腔灌洗液,采用流式细胞仪DNA倍体分析技术计数其中的肝癌细胞数量,并对术后腹腔内种植转移情况进行随访。结果肝癌术中腹腔灌洗液中游离癌细胞计数与术后腹腔内种植转移的发生率存在一定的相关性(r=0.628),其中术中肝癌破裂组、肝癌部分切除组、肝癌自发破裂组为术后发生种植转移的高危组。结论肝癌术中腹腔内游离癌细胞数量对术后种植转移的发生率有一定的预测作用,通过采取有效的措施以减少肝癌术中腹腔内游离癌细胞对术后种植转移的发生有一定的预防作用。

Objective For early diagnosis, prediction and prevention of seeding metastasis after operation of liver cancer, the correlation of the number of intraoperative scattering tumor cells in peritoneal cavity and the incidence of the postoperative seeding metastasis were investigated. Methods Intraoperative peritoneal lavage fluid from 128 cases of primary liver cancer was collected. Then the number of tumor cells in it was counted by flowcytometer with DNA diploid analysis. The follow-up for postoperative seeding metastasis lasted 6-18 months. Results The result showed there was a certain correlation between the scattering tumor cell counting in intraoperative peritoneal lavage fluid and the incidence of the postoperative seeding metastasis （r=0.628）. The patients of intraoperative ruptured, partial resected and spontaneous ruptured liver cancer were in high risk of postoperative seeding metastasis. Conclusion The number of intraoperative scattering tumor cells in peritoneal cavity has predictable value for the incidence of postoperative seeding metastasis of liver cancer. Some maneuvers to decrease the scattering tumor cells during the operation of liver cancer may play a relative effective role in preventing the occurrence of its seeding metastasis after operation.