腹腔镜胃癌根治术及TNM分期对肿瘤细胞腹腔转移的影响

The Influence of Laparoscopic Radical Gastrectomy and TNM Stages on Tumor Cell Peritoneal Metastasis

目的:探讨腹腔镜胃癌根治术及TNM分期对肿瘤细胞腹腔转移的影响。方法:80例接受胃癌根治术治疗的患者,根据手术方式随机分为观察组(腹腔镜胃癌根治术)与对照组(常规开腹胃癌根治术),比较两组患者术前、术后腹腔冲洗液中检出肿瘤细胞的病例数,并探讨腹腔液检出肿瘤细胞的病例与肿瘤TNM分期的关系。结果:两组胃癌患者术前、术后腹腔冲洗液中检出肿瘤细胞病例数比较,差异无统计学意义(P>0.05);两组Ⅲ期胃癌患者术前及术后腹腔冲洗液中检出肿瘤细胞病例数显著高于Ⅱ期胃癌患者,差异有统计学意义(P<0.01)。结论:腹腔镜胃癌根治术对于胃癌细胞腹腔转移率影响较小,而TNM分期对于肿瘤细胞腹腔转移液影响较大。

Objective： To investigate the influence of laparoscopic radical gastrectomy,TNM stages on tumor cell peritoneal metastasis. Methods： Eighty patients with gastric cancer were divided into two groups： observe group（ laparoscopic radical gastrectomy） and control group（ conventional open gastric resection）. Comparing detection rate of tumor cells in peritoneal washing fluid before and after surgery,exploring relationship between detection of tumor cells in peritoneal washing fluid and TNM stages.Results： There was no statistical difference in comparison of detection of tumor cells in peritoneal washing fluid before and after surgery in two groups（ P〉0. 05）. The positive detection rate of tumor cells in peritoneal washing fluid of patients with stage Ⅲ before and after surgery was obviously higher than stage Ⅱ patients,the differences were statistical significant（ P〈0. 01）. Conclusion： The influence of laparoscopic radical gastrectomy on tumor cells in peritoneal metastasis is minor,while influence of TNM stage on peritoneal fluid is huge.