摘要
目的探讨胃癌腹腔微转移情况的检测方法及意义。方法手术中切除肿瘤前收集腹腔冲洗液,采用磁激活细胞分离术(MACS)对不同病理分期胃癌患者腹腔冲洗液中癌细胞进行富集并检测。分别标记带磁珠的细胞角蛋白(CK)抗体,经磁柱富集CK+上皮细胞,用流式细胞仪检测其含量,并比较胃癌组与胃平滑肌瘤组(对照组)以及胃癌不同分期之间、磁富集前后CK+上皮细胞含量的差异。结果在未经MACS富集的标本中较少发现CK+CD45-细胞;在富集后的标本中其含量在胃癌组与对照组有显著差异(41/50,1/10,P<0.001);pTNMⅠ～Ⅱ期与Ⅲ～Ⅳ期之间(0.67%,3.42%,P<0.001)差异有非常显著性。结论MACS能有效地富集上皮来源细胞,提高上皮源细胞的检出率,并能反映腹腔游离癌细胞数量;上皮细胞数量与胃癌的存在及临床病理分期有关,其有利于判断肿瘤转移和预后并指导治疗。
Objective To study a method for the detection of peritoneal micrometastasis of gastric cancer （GC） and its significance. Methods During operation, peritoneal washings were collected before tumor resection in patients with various stages of gastric cancer, and the tumor cells in the peritoneal lavage were enriched, collected and analyzed using magnetic activated cell sorting （MACS） technique. The cells were labeled by antiytokeratin （ CK ） antibody with magntic microbeads and passed through magnetic columns. The CK^＋ epithelial cells were quantified by flow cytometry and the differences of amount of CK^＋ epithelial cells collected before and after magentic enrichment in the gastric cancer group and the control group, and between different stages of gastric cancer were compared. There were 50 cases in gastric cancer group and 10 cases of gastric leiomyoma in the control group. Results CK^＋ CD45^- cells were rarely detected in the samples without MACS; in the samples treated by MACS, the concentrations of CK^＋ CD45^- cells were significantly higher in GC group than in control group（41/5Ovsl/lO,P 〈 0. 001 ） , and lower in pTNM stage Ⅰ - Ⅱ group than in stageⅢ - Ⅳ group. （ 0. 67% vs 3. 42% , P 〈 0. 001 ） Conclusions MACS can effectively enrich epithelial tumor cells in peritoneal lavage, increase the detection rate of epithelial-derived cells, and close relationships were found between CK^＋ CD45^- cell concentrations with free tumor cells and clinicopathologic stages. The technique could become a valuable tool to evaluate the risk of cancer metastasis and prognosis and to guide therapy.
出处
《中国普通外科杂志》
CAS
CSCD
2007年第4期301-304,共4页
China Journal of General Surgery
关键词
胃肿瘤
肿瘤转移
腹腔灌洗
磁激活细胞分离术
游离癌细胞
流式细胞术
Stomach Neoplasms
Neoplasms Metastasis
Peritoneal Lavage
Magnetic Activated CellSorting（MACS）
Free Cancer Cell
Flow Cytometry
