RT-PCR检测胃癌腹腔液中癌细胞CEA mRNA的表达预测腹膜微转移的研究

Detection of CEA mRNA Expression in Cancer Cells from Peritoneal Irrigation Fluid by RT-PCR in Gastric Cancer Patients Predicting the Micrometastases to Peritoneum

目的 :探讨RT PCR方法检测腹腔冲洗液中游离细胞的CEAmRNA表达 ,对预测胃癌腹膜亚临床转移的意义。方法 :收集 43例胃癌和 7例胃良性病变患者的术中腹腔冲洗液 ,用RT PCR方法测定冲洗液中游离细胞的CEAmRNA表达 ,同时作冲洗液细胞学检查 (PLC)。结果 :腹腔冲洗液游离细胞的CEAmRNA的表达量随病期的进展、浸润深度的加深而逐渐升高 (P <0 .0 1) ;因胃浆膜类型和大体类型的不同其阳性级别亦存在明显差异 (P<0 .0 1)。结论 :CEART -PCR方法对于检测腹腔微量游离癌细胞较PLC有更高的灵敏度和特异性 ,是一种检测胃癌腹膜微转移的较好方法。

Objective: To study the expression mRNA of CEA in free cells from peritoneal irrigation fluid in gastric cancer patients and its significance for predicting the subclinical peritoneal metastases.Methods: The mRNA of CEA expression in free cells from intraperitoneal irrigation fluid in 43 cases of gastric cancer and 7 cases of benign gastric disease were determined by RT-PCR method, and the cytological changes of the irrigation fluid was examined.Results: Twenty-four of 43 gastric cancer patients including 14 patients with positive cytological results were proved positive for CEA mRNA. None of 7 patients with benign gastric disease was positive. Moreover, the value of CEA mRNA expression escalated with the progression of the disease and depth of invasion (p<0.01).Conclusion: mRNA of CEA is more sensitive and specific than cytologic examination for detecting scanty cancer cells in peritoneal cavity. Therefore, it is a better method in detecting peritoneal micrometastases in gastric cancer patients.