| 流式细胞术检测胃癌手术前后腹腔冲洗液CEA的变化及意义 |
| Alternative Title | Changes of CEA detected by flow cytometry in peritoneal lavage after gastrectomy and its clinical significance
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| 张贤坤 |
| Thesis Advisor | 刘宏斌
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| 2009-05-22
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 流式细胞术
胃癌手术
腹腔冲洗液
癌胚抗原
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| Abstract | 目的：1、探索检测胃癌患者腹膜微转移的方法；2、探讨胃癌手术对腹腔脱落癌细胞的影响。
方法 收集50例行胃癌手术患者胃癌切除前后腹腔冲洗液，以流式细胞学（FCM）方法检测腹腔冲洗液癌胚抗原（CEA），同时采用HE染色进行腹腔冲洗液细胞学（PLC）检查。 取9例胃良性病变患者的腹腔冲洗液行FCM及PLC检查，作为对照。
结果：1、胃癌患者腹腔冲洗液中CEA的术前检出率为46%（23/50），明显高于PLC的20%（10/50）,且阳性率随肿瘤浸润深度、TNM分期、浆膜受累及淋巴结转移程度增加而增加。9例胃良性病变者腹腔液流式细胞学CEA检查及PLC检查结果均为阴性。 2、胃癌手术患者CEA检查胃癌未切除时阳性率为46%（23/50），切除后阳性率为64%（32/50），两组之间差异有统计学意义（P<0.05）。PLC检查结果手术前后分别为20%（10/50）和36%（18/50）（P<0.05）。术前PLC阳性者术前FCM均为阳性，术后PLC阳性者术后FCM均为阳性。FCM阴性者PLC均为阴性。9例良性病变者FCM及PLC检查结果均为阴性。
结论 1、FCM方法检测腹腔冲洗液CEA是检测腹腔游离癌细胞和预测腹膜转移的有效方法，有望成为术中腹腔化疗个体化的指导依据。 2、胃癌手术增加腹腔游离癌细胞的脱落。该方法可为评价手术效果、判断预后及为围手术期综合治疗提供依据。 |
| Other Abstract | Objective 1、To explore a method for predicting peritoneal micrometastasis in gastric carcinoma patients. 2、To investigate the effect of gastrectomy on gastric cancer cells in peritoneal lavage fluid from patients with gastric cancer.
Methods Peritoneal lavage fluid from 50 patients with gastric cancer and 9 patients with benign diseases were collected before and after gatrectomy to detect carcinoembryonic antigen（CEA）using FCM. The peritoneal lavage cytology examinations（PLC）were carried out by H-E staining.
Results 1、Amonf 50 cases of gastric cancer，the positive rate of CEA in peritoneal washings was 46%（23/50），which was significantly higher than that of PLC 20%（10/50）. The positive rate of CEA concurrently increased with the depth of tumor invasion , TNM staging，lymph node metastasis and serosal involvement. None of the 9 patients with benign diseases were positive. 2、The pre-, and postoperative CEA positive rate was 46%（23/50）and 64 %（32/50）, respectively，and there was significant difference（P<0.05）. The pre-, and postoperative PLC positive rate was 20%（10/50）and 36%（18/50）（P<0.05）。
Conclusions 1、The detection of CEA by FCM serves better to predict patients who will develop peritoneal metastasis and cancer recurrence. 2、Gastrectomy increases the intraperitoneal free cancer cells. |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/223047
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
张贤坤. 流式细胞术检测胃癌手术前后腹腔冲洗液CEA的变化及意义[D]. 兰州. 兰州大学,2009.
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