原发性肝细胞癌92例患者腹腔脱落癌细胞阳性率分析

Relationship between positive peritoneal exfoliated cancer cells and the clinicopathological features in patients with hepatocellular carcinoma： a retrospective study of ninety-two patients

目的探讨原发性肝细胞癌侵入性操作前腹腔脱落癌细胞阳性率与临床病理特征的关系.方法92例原发性肝细胞癌患者开腹后有腹腔积液者直接收集腹腔积液,无腹腔积液者收集腹腔灌洗液,检测腹腔脱落癌细胞的阳性率.结果腹腔脱落癌细胞阳性检出率与TNM分期、肿瘤位置、肿瘤大小显著相关.TNM分期Ⅲ、Ⅳ期肝癌腹腔脱落癌细胞阳性检出率显著高于Ⅰ、Ⅱ期（38.1％比8.0％,P=0.0005）.肿瘤位置越接近表面（P=0.0002）、直径越大（P=0.00007）,腹腔脱落癌细胞阳性检出率越高.结论腹腔脱落癌细胞与肝细胞癌分期进展、肿瘤位置、大小明显相关.

Objective To investigate the relationship between positive peritoneal exfoliated cancer cells and the clinicopathological features of patients with hepatocellular carcinoma before any invasive treatment.Methods Of the 92 patients with hepatocellular carcinoma who underwent laparotomy,ascites fluid was collected in the patients with peritoneal ascites; and peritoneal lavage fluid was collected in those patients without peritoneal ascites.Then,shedded cancer cells in these fluid samples were detected.Results The positive rates of peritoneal cancer cells were associated with the TNM stage,tumor location and tumor size.The positive detection rate of cancer cells in TNM stage Ⅲ and Ⅳ was significantly higher than stage Ⅰ and Ⅱ （38.1% vs 8.0% ; P =0.0005）.The positive detection rate was higher in tumors located closer to the surface （P =0.0 002）,and with larger diameter （P =0.00 007）.Conclusion Peritoneal cancer cells were significantly correlated with tumor stage,tumor location and size in hepatocellular carcinoma.