开腹与腹腔镜胃癌根治术患者腹腔冲洗液中肿瘤细胞检出率与基质金属蛋白酶7和癌胚抗原表达的相关性分析

摘要

Objective To investigate the relation among tumor cell detection rate and expressions of matrix metalloproteinase-7 (MMP-7) and carcinoembryonic antigen (CEA) in peritoneal lavage fluid of patients undergoing open and laparoscopic radical resection of gastric cancer.Methods Thirty-six patients undergoing laparoscopic radical gastrectomy and 40 patients undergoing open gastrectomy for gastric cancer were enrolled from October 2014 to March 2017 in People's Hospital of Danzhou.Peritoneal lavage fluid was collected before and after resection of gastric tumor;tumor cell detection rate and expressions of MMP-7 and CEA in lavage fluid were tested.Results There were no significant differences of positive expression rates of MMP-7 and CEA in peritoneal lavage fluid between open gastrectomy patients and laparoscopic gastrectomy patients (P ＞ 0.05).There was no significant difference of tumor cell detection rate in peritoneal lavage fluid between open gastrectomy patients and laparoscopic gastrectomy patients(P ＞0.05).After resection of tumor,19 open gastrectomy patients were detected tumor cells in peritoneal lavage fluid,among them 18 cases (94.7％) showed positive MMP-7 and 17 cases (89.5％) showed positive CEA;21 patients had negative results of tumor cell detection,including 12 cases (57.1％) with positive MMP-7 and 4 cases(19.0％) with positive CEA;tumor cell detection rate was positively related to expressions of MMP-7 and CEA (r =0.553,0.704;P ＜ 0.05).After resection of tumor,16 laparoscopic gastrectomy patients were detected tumor cells in peritoneal lavage fluid,15 cases (93.8％) of them showed positive MMP-7 and 14 cases(87.5％) showed positive CEA;20 patients had negative results of tumor cell detection,11 cases(55.0％) had positive MMP-7 and 5 cases(25.0％) had positive CEA;tumor cell detection rate was positively related to expressions of MMP-7 and CEA (r =0.430,0.622;P ＜ 0.05).Conclusions Tumor cell detection rate is closely related to expressions of MMP-7 and CEA in peritoneal lavage fluid of patients with radical resection of gastric cancer.Laparoscopic gastrectomy will not increase the possibility of tumor cell dissemination.%目的 探讨开腹与腹腔镜胃癌根治术患者腹腔冲洗液中肿瘤细胞检出率与基质金属蛋白酶7(MMP-7)和癌胚抗原表达的相关性.方法 选择2014年10月至2017年3月海南省儋州市人民医院肿瘤科行腹腔镜胃癌根治术患者36例、开腹胃癌根治术患者40例;在手术切除肿瘤组织前后收集腹腔冲洗液测胃癌细胞检出率,流式细胞方法检测MMP-7、癌胚抗原的表达.结果 切除胃癌组织前及切除后,开腹组和腹腔镜组之间腹腔冲洗液中MMP-7和癌胚抗原阳性表达率差异均无统计学意义(均P＞0.05).切除胃癌组织前及切除后,开腹组和腹腔镜组之间腹腔冲洗液中胃癌细胞检出率差异均无统计学意义(均P＞0.05).开腹组切除肿瘤组织后腹腔冲洗液中胃癌细胞检出阳性19例,其中MMP-7阳性18例(94.7％)、癌胚抗原阳性17例(89.5％),腹腔冲洗液中胃癌细胞检出阴性21例,其中MMP-7阳性12例(57.1％)、癌胚抗原阳性4例(19.0％),胃癌细胞检出率与MMP-7、癌胚抗原的表达呈正相关(r=0.553、0.704,均P＜0.05).腹腔镜组切除肿瘤组织后腹腔冲洗液中胃癌细胞检出阳性16例,其中MMP-7阳性15例(93.8％)、癌胚抗原阳性14例(87.5％),腹腔冲洗液中胃癌细胞检出阴性20例,其中MMP-7阳性11例(55.0％)、癌胚抗原阳性5例(25.0％),胃癌细胞检出率与MMP-7、癌胚抗原的表达呈正相关(r=0.430、0.622,均P＜0.05).结论 腹腔冲洗液中肿瘤细胞检出率与MMP-7、癌胚抗原的表达密切相关.腹腔镜手术并未明显增加癌细胞脱落的机会.