应用流式细胞术检测胃癌患者术中腹腔冲洗液脱落细胞的临床研究

Clinical Study on the Use of Flow Cytometry in Detecting Exfoliated Cancer Cells in Peritoneal Washing Fluids from Gastric Carcinoma Patients

目的:应用流式细胞技术(flow cvtometry,FCM)对腹腔冲洗液进行DNA倍体分析,作为胃癌腹腔脱落癌细胞(exfoliat-ed canceF cells,,ECC)检测的辅助手段为临床提供依据方法:收集62例胃癌患者术中腹腔冲洗液,应用FCM进行脱落细胞DNA倍体分析,同时行腹腔冲洗液细胞学(peritoneal lavage eytologv,PLC)检查,比较二者的检测敏感度,并分析FCM与胃癌不同临床病理特征的相关性结果:62例胃癌腹腔冲洗液流式细胞术DNA倍体分析检测阳性率为67.74%,而PLC阳性率仅为33.87%,两组差异有统计学意义(P<0.001)肿瘤类型、浸润深度、受侵面积、淋巴结转移、脉管瘤栓、TNM分期与腹腔冲洗液异倍体肿瘤细胞相关(P均>0.05)在局限性胃癌、肿瘤浸润深度、浆膜受侵面积<10cm^2、淋巴结转移、无脉管瘤栓、TNM分期方面腹腔冲洗液FCM检测阳性率优于PLC(P均<0.05)结论:流式细胞术可作为胃癌患者术中检测ECC的有效辅助诊断手段。

Objective： To provide clinical evidence of the fluids of gastric carcinoma patients using flow cytometry （ FCM detection of exfoliated cancer cells （ ECC ） from peritoneal washing ） as an assisting approach. Methods： Peritoneal washings and related clinical data from 62 patients with gastric cancer were collected. FCM was used to carry out DNA ploidy analysis of ECC, whereas traditional peritoneal lavage cytology （ PLC ） was used to compare the sensitivity of the two methods. The correlation between FCM results and the clinicopathologic features of gastric cancer was analyzed. Results： The positive rate of 62 cancer patients was 67.74% and 33.87% in the FCM and PLC groups, respectively. Significant differences were observed between the two groups （ P 〈 0.001 ）. FCM was correlated with tumor type （ P = 0.013 ）, infiltration depth （ P = 0.018 ）, area of serous invasion （ P = 0.048 ）, nodal metastasis （ P = 0.001 ）, vascular tumor embolus （ P = 0.048 ）, and clinicopathologic staging based on the tumor, nodes, and metastasis classification （ TNM staging ） （P = 0.002 ）. FCM was superior to PLC in localizing gastric cancer （ P = 0.003 ）, infiltration depth （ P 〈 0.01 ）, invasion area of peritoneum below 10 cm2 （ P = 0.001 ）, lymph node metastasis （ P = 0.001 ）, vessel tumor embolus negative （ P - 0.001 ）, and TNM staging （ P 〈 0.05 ）. Conclusion： FCM can be used as an effective method to detect ECC during surgery and to assist in the diagnosis of gastric cancer.