腹腔冲洗液L3-PP和整合素α5β1检测对胃癌腹膜种植转移预测价值分析

Significance of detecting L3-PP and intergrin-α5β1 of peritoneal washing in predicting peritoneal implantation metastasis of gastric cancer

目的:探讨检测腹腔冲洗液中L3-PP和整合素α5β1对于预测胃癌腹膜种植转移的意义。方法:收集96例胃癌患者腹腔冲洗液,用RT-PCR方法测定冲洗液中游离细胞L3-PP、整合素α5β1及CEA mRNA的表达情况,同时作冲洗液细胞学检查(PLC)。结果:腹腔冲洗液中的L3-PP、α5β1和CEA mRNA的阳性率分别为74.0%(71/96)、65.6%(63/96)和62.5%(60/96),均高于腹腔冲洗液细胞学21.9%(21/96),差异均有统计学意义,χ2值分别为52.174、37.333和32.480,P值均<0.01。L3-PP、α5β1及CEA mRNA的阳性率与肿瘤的浸润深度(χ2=7.898,P=0.046;χ2=10.692,P=0.014;χ2=7.897,P=0.048)、TNM分期(χ2=21.960,P<0.01;χ2=29.266,P<0.01;χ2=22.291,P<0.01)、腹膜转移(χ2=13.919,P<0.01;χ2=16.627,P<0.01;χ2=9.089,P<0.01)等密切相关。对CEA-组和CEA+组的生存分析发现差异均有统计学意义(Log-rank test=8.349,P=0.039;Log-rank test=10.864,P=0.012)。结论:用RT-PCR联合检测腹腔冲洗液中L3-PP和整合素α5β1mRNA可作为预测胃癌腹膜种植转移的方法,为临床医生选择合适的治疗方案提供依据。

OBJECTIVE： To explore the expression of 1.3-PP and a5B1-integrin of peritoneal washing and their sig nificanees in the prediction of peritoneal metastasis of gastric cancer. METHODS： The peritoneal washings were collected during laparotomy from 96 patients with gastric cancer. The expression of 1.3-PP,a5fll-integrin and CEA mRNA were de- tected by reverse transcription polymerase chain reaction （RT PCR）. RESULTS： The positive expression rates of 1.3 PP, a5B1 and CEA mRNA were 7,1. 0% （21/96）,65. 6% （63/96） and 62. 5% （60/96）,respectively,which were higher than that of cytological examination 21.8%（21/96）,and there were statistically significant difference（ X2=52. 174,P（0.01 X2= 37. 333,P〈0.01 ;X2=32. 480,P（0.01,respectively）. The postive expression rates of [.3-PP,a5B1 and CEA mRNA were correlated with the depth of invasion（ X2 = 7. 898, P= 0. 046 ; X2= 10. 692, P= 0.01,X2 = 7. 897. P = 0. 048, respec- tively）. TNM staging（ X2= 21. 960, P〈0.01 ; X2= 29. 266, P〈0.01 ; X2 = 22.291, P〈0.01, respectively）, peritoneal dis- semination（xe 13.919,P〈0.01;X2=16.627,P〈0.01;X2=9.089,P〈0.01,respectively）. The survival analysis of CEA negative group and CEA positive group were statistically significant difference（ Log-rank test = 8.3,19, P = 0. 039; l.og-rank test= 10. 864 ,P= 0. 012, respectively）. CONCLUSIONS： The detection of 1.3-PP and a5B1-integrin mRNA by RT-PCR may be used as a new method for predicting peritoneal implantation metastasis of gastric cancer,and provide an evidence for clinicians to select appropriate therapeutic scheme.