不同腹腔灌洗量对进展期胃癌根治术患者腹腔脱落细胞检出率的影响

Influence of Different Volume of Peritoneal Lavage Fluid on Positive Rate of Exfoliated Cancer Cells in Radical Gastrectomy for Advanced Gastric Cancer

目的:探讨不同灌洗量对进展期胃癌腹腔脱落细胞检出率的影响。方法:回顾性分析75例胃癌根治术及腹腔灌洗的进展期胃癌患者的临床病理资料,分析腹腔脱落细胞检出率与腹腔灌洗量的关系及影响检出率的病理因素。结果:75例腹腔脱落细胞检查阳性率为32.0%,病理分期、浸润深度、分化程度、淋巴结转移及腹腔灌洗量与腹腔脱落细胞阳性检出率显著相关(P<0.05);多因素logistic回归显示,浸润深度、淋巴结转移、腹腔灌洗量是影响阳性检出率的危险因素。结论:灌洗量是影响进展期胃癌腹腔脱落细胞阳性检出率的因素,适当增加灌洗量(>2000 mL)可促进游离癌细胞的清除,提高脱落细胞阳性检出率。

Objective To explore the impact of different volume of peritoneal lavage fluid on positive rate of exfoliated cancer cells in radical gastrectomy for advanced gastric cancer.Methods Clinic pathological data of 75 patients with advanced gastric carcinoma who receive radical gastrectomy and peritoneal lavage were analyzed retrospectively,the correlation of volume of peritoneal lavage fluid with positive rate of exfoliated cancer cells,associated clinic pathological factors was analyzed.Results The positive rate of exfoliated cancer cells of 75 patients with advanced gastric carcinoma was 32.0%.There was significant correlation between positive rate of exfoliated cancer cells with stage,infiltration depth,degree of tumor differentiation,retrieved lymph nodes and volume of peritoneal lavage fluid（P〈0.05）.Multiple logistic regression analysis showed that infiltration depth,retrieved lymph nodes and volume of peritoneal lavage fluid were risk factors of positive rate of exfoliated cancer cells in patients with advanced gastric cancer（P〈0.05）.Conclusion Volume of peritoneal lavage fluid was an influence factor of positive rate of exfoliated cancer cells in advanced gastric cancer.Increasing peritoneal lavage fluid（2000 mL）could promote the removal of free cancer cells,improve the positive rate of exfoliated cancer cells.