摘要
目的探讨胃癌患者腹腔游离癌细胞形成的相关因素及其与胃癌根治术后预后的关系。方法对61例胃癌手术患者施行术中腹腔冲洗液细胞学检测,分析其临床病理特征与腹腔游离癌细胞形成的相关性,通过多元回归分析和累积生存曲线分析预后及相关因素。结果61例胃癌患者腹腔冲洗液细胞学阳性率为36%,Ⅲ、Ⅳ期胃癌、浆膜受累、淋巴结受侵及血管癌栓、术后腹膜转移者阳性率分别为50%、47%、45%、65%、88%,明显高于Ⅰ、Ⅱ期胃癌(19%)、浆膜未侵(22%)、无淋巴结受侵(12%)、无血管瘤栓(18%)及其他转移者(33%)。腹腔游离癌细胞是胃癌预后的独立危险因素(RR=3·614,P=0·02),腹腔冲洗液细胞学阳性组的生存时间明显缩短(P<0·01)。结论腹腔游离癌细胞形成微转移灶是胃癌根治术后腹腔复发转移及预后的危险因素,术中腹腔冲洗液细胞学检测有助于判断预后。
Objective To explore the correlation between peritoneal free cancer cells （FCC） and the prognosis of gastric cancer patients undergoing gastrectomy. Method Peritoneal washing cytology（PWC） was performed with 61 gastric cancer patients. Positive cytology in relation to the clinicopathological features was analyzed prospectively. Kaplan-Meier method and Cox＇s analysis were used to analyze the survival and the prognostic factors. Results The total positive cytology rate was 36%. Positive cytology in cases of stage Ⅲ and Ⅳ （ 50% ） , serosal invasion （ 47% ） , lymph node involvement （ 45% ） , vascular invasion（65% ）and postoperative peritoneal metastasis （88%） were much high than in cases with stage Ⅰand Ⅱ （ 19% ） , nonserosal invasion （ 22% ） , negative lymph node （ 12% ） , negative vascular invasion （18%） and other metastasis （33%）. Positive cytology was the independent prognostic factor affecting survival （ RR = 3. 614, P = 0. 020 ）. Survival of those with positive cytology was lower than that of with negative findings （ P 〈 0. 01 ）. Conclusion FCCs are responsible for postoperative peritoneal dissemination and useful indicator of the prognosis for gastric cancer patients undergoing gastrectomy.
出处
《中华普通外科杂志》
CSCD
北大核心
2005年第7期414-416,共3页
Chinese Journal of General Surgery
