大网膜在胃癌腹膜微转移检测中的价值

Value of Great Omentum in Detection of Gastric Cancer Peritoneal Micrometastasis

目的探讨大网膜在胃癌腹膜微转移检测中的价值。方法采用实时荧光定量RT-PCR检测36例胃癌患者和6例非肿瘤开腹手术患者大网膜及腹腔冲洗液CK20mRNA,大网膜取材分邻近网膜血管1、2级分支取材和无血管区取材两种方式,通过统计学方法分析大网膜在胃癌腹膜转移中的价值。结果胃癌患者腹腔冲洗液检测CK20mRNA阳性率为55.5%(15/30),大网膜邻近血管取材检测阳性率为43.33%(13/30),无血管区取材检测阳性率为6.66%(2/30),大网膜检测阳性者,冲洗液检测均阳性;冲洗液检测阳性者,大网膜检测不一定阳性,非肿瘤开腹手术患者腹腔冲洗液及大网膜检测均为阴性。结论利用大网膜检测胃癌腹膜转移阳性率与腹腔冲洗液相似,腹腔冲洗液检测是一种预测性指标,大网膜检测是一种确定性指标,邻近血管区是更好的取材方式。

ObjectiveTo explore the value of great omentum in gastric cancer peritoneal micrometastasis detection. MethodsReal-time quantitative RT-PCR was used to detect CK20mRNA in great omentum and peritoneal washing fluid of 36 gastric cancer patients and 6 abdominal surgery patients without tumor.Collecting means of great omentum included adjacent sub-branches of omental 1,2 grade vessels and non-vascular area.Statistical methods were used to analyze the value of greater omentum in detecting gastric cancer peritoneal metastasis. ResultsCK20mRNA positive rate of peritoneal lavage fluid was 50% （15/30）.Positive rate of greater omentum close to blood vessels was 43.33% （13/30）.And positive rate of greater omentum in non-vascular area was 6.66% （2/30）. Flushing fluid testing must be positive while omentum was positive, but greater omentum tests may not be positive while washing fluid testing positive. Peritoneal lavage fluid and omentum test were negative for paitients undergoing abdominal operation without tumor. ConclusionThe positive rate of great omentum was lower than that of peritoneal lavage fluid in paitients with gastric cancer.The peritoneal lavage fluid testing is a predictive indicator while the omentum testing is a deterministic target detection,and materials near the omental 1,2 grade vessels is better for testing.