胃癌腹膜转移与腹腔灌洗液中端粒酶活性的关系

Relationship between Telomerase Activity of Peritoneal Washing and Peritoneal Dissemination of Gastric Carcinoma

目的：探讨胃癌患者腹腔灌洗液中端粒酶活性与胃癌腹膜转移的关系。方法：应用端粒重复扩增（ＴＲＡＰ）－酶联免疫吸附测定（ＥＬＩＳＡ）法检测４６例胃癌和１４例胃溃疡患者腹腔灌洗液中的端粒酶活性，同时对４６例胃癌患者行腹腔灌洗液脱落细胞学检测。结果：１４例胃溃疡患者腹腔灌洗液中端粒酶活性均为阴性。胃癌患者腹腔灌洗液中端粒酶活性阳性率在ＰＴ３期胃癌为５５．６％，在ＰＴ４期胃癌为９９．３％；在浆膜未受累组、受累面积＜１０ ｃｍ２组、１０．１～２ ０ ｃｍ２组和＞２０ｃｍ２组分别为５．３％、２５．０％、７６．９％和１００．０％；在无肉眼可见腹膜转移灶（Ｐ０）组为４２．９％，在肉眼可见腹膜转移灶（Ｐ１～３）组为１００．０％。而腹腔灌洗液中脱落细胞学检测阳性率在ＰＴ３和ＰＴ４期胃癌分别为２２．２％和６１．５％；在浆膜未受累组、受累面积＜ １０ ｃｍ２组、 １０．１～２０ ｃｍ２组和＞ ２０ ｃｍ２组分别为０、０、３８．５％和７０．０％；在Ｐ０组为１９．０％，在Ｒ１～３组为１００．０％。ＴＲＡＰ－ＥＬＩＳＡ方法的阳性率比脱落细胞学检测显著增高（４７．８％比２６．１％，Ｐ＜０．０５）。结论：腹腔灌洗液中的端粒酶活性与胃癌腹膜转移呈正相关，

Background/Aims: To appraise the relevance of telomerase activity of peritoneal washing and peritoneal dissemination of gastric carcinoma. Methods: Telomeric repeated amplification protocol (TRAP)-enzyme-linked immunosorbent assay (ELISA) was performed on peritoneal washing collected from 46 gastric carcinoma patients and 14 gastric ulcer patients. Exfoliative cytologic analysis was used for comparison. Results: No telomerase activity was found in 14 gastric ulcer patients' peritoneal washing. The positivity rates of telomerase activity in peritoneal washing collected from PT3 and PT4 gastric carcinoma were 55.6% and 99.3%, respectively; from surface area of serosal involvement 0, < 10 cm2, 10.1-20 cm2 and > 20 cm2 were 5.3%, 25.0%, 76.9% and 100.0%, respectively; and from invisible (P0) and visible peritoneal dissemination (P1-3) were 42.9% and 100.0%, respectively. Meanwhile the positivity rates of exfoliative cytology in peritoneal washing collected from PT, and PT, gastric carcinoma were 22.2% and 61.5%, respectively; from surface area of serosal involvement 0, < 10 cm2, 10.1-20 cm2 and > 20 cm2 were 0, 0, 38.5% and 70.0%, respectively; and from P0 and P1-3 were 19.0% and 100.0%, respectively. The positivity rate of TRAP-ELISA was significantly higher than that of exfoliative cytology (47.8% vs 26.1%, P<0.05). Conclusions: There is positive correlation between telomerase activity of peritoneal washing and peritoneal dissemination of gastric carcinoma. Telomerase activity can be used to reflect the status of peritoneal dissemination and as an indicator for its early diagnosis.