胃癌患者腹腔游离癌细胞检出率的研究

STUDY OF DETECTABLE RATE OF FREE CANCER CELLS OF PATIENTS WITH GASTRIC CANCER

通过胃癌患者腹腔游离癌细胞的定性研究 ,为术中无瘤技术、常规腹腔冲洗及术后温热灌注化疗提供理论依据。对我院 10 2例胃癌患者行探查前和关腹前各收集 10 0ml腹腔液 ,迅速送检 ,作游离癌细胞检查。结果探查前游离癌细胞阳性率为 36 .3% ,关腹前游离癌细胞阳性率为 5 2 .9% ,游离癌细胞阳性率与肿瘤浸润深度 ,浆膜受侵面积及病理组织类型有关。结论 :胃癌患者腹腔内可有游离癌细胞存在 ,且具有较高活性。尽管采取各种无瘤操作措施 ,仍难免肿瘤细胞脱落进入腹腔。手术过程中的创伤刺激可增加癌细胞的脱落 ,术中采取无瘤技术和大量生理盐水冲洗腹腔是必要的 ,更主要的是对游离癌细胞阳性者术后要进行腹腔内温热灌注化疗。

Through the qualitative study of peritoneal cavity free cancer cells of patients with gastric cancer, to evaluate the rational of exercising intraoperative no touch isolation technique, routine peritoneal and warm perfusion chemotherapy after the operation. 102 patients in PLA 309 Hospital with gastric cancer were included into the study. 100 ml peritoneal fluid were collected respectively before the investigation and before close peritoneal cavity,and rapidly sent for free cancer cells examination. Results: Before the investigation, the positive rate of free cancer cells is 36.3%, and the positive rate before close peritoneal cavity is 52.9%. The free cancer cells positive rate is concerned with tumor infiltration depth, serous membrane infection area and the type of the histopathology。Conclusions: Inside the peritoneal cavity of patients with gastric cancer, free cancer cells are able to survive and have a high degree of activity. Although all kinds of intraoperative no touch isolation technique are used, it still cannot be avoided that some cancer cells will exfoliate and slip into the peritoneal cavity. The wound stimulation during the operation will certainly increase the exfoliation. So, it is quite necessary in the course of operation to adopt no touch isolation technique and to use a great deal of normal saline to give peritoneal cavity lavage. And what's more important is, to give these patients who show positive in the free cancer cell examination perfusion chemotherapy after the operation.