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目的:探讨腹腔冲洗液Cox-2mRNA及CEA mRNA检测的可行性和临床意义。方法:前瞻性比较胃癌腹腔冲洗液RT-PCR法与常规细胞学法(PLC)检出脱落癌细胞的阳性率。结果:32例胃癌患者腹腔冲洗液中Cox-2mRNA及CEA mRNA检出阳性率分别为53.1%(17/32)及56.3%(18/32),明显高于PLC检出癌细胞阳性率(21.9%),χ2分别为5.497及4.433,P<0.05。17例RT-PCR法检出阳性病例中,Cox-2mRNA法检出16例(94.1%),CEA mRNA法检出15例(88.2%),两种基因腹腔冲洗液脱落癌细胞检测阳性率大致相同,且检测阳性率与浆膜浸润阳性、浆膜浸润面积大、病理组织学类型、淋巴结转移和TNM病期呈正相关。结论:RT-PCR法检测胃癌腹腔冲洗液Cox-2mRNA与CEA mRNA表达,可显著提高脱落癌细胞的检测阳性率,具有广泛的临床应用价值和意义。
Objective: To investigate the feasibility and clinical significance of Cox-2 mRNA and CEA mRNA in peritoneal washings. Methods: Prospectively compare the positive rate of cancerous cells detected by RT-PCR and conventional cytology (PLC). Results: The positive rates of Cox-2 mRNA and CEA mRNA in peritoneal wash fluid of 32 gastric cancer patients were 53.1% (17/32) and 56.3% (18/32) respectively, which were significantly higher than that of PLC (21.9% %), χ2 = 5.497 and 4.433 respectively (P <0.05). Among the 17 positive cases detected by RT-PCR, Cox-2 mRNA was detected in 16 cases (94.1%) and CEA mRNA was detected in 15 cases (88.2% The positive rates of two gene exfoliative cancer cells in peritoneal washings were approximately the same, and the positive rates of detection were positively correlated with positive serosal invasion, large serosal invasion area, histopathological types, lymph node metastasis and TNM stage. Conclusion: The detection of Cox-2 mRNA and CEA mRNA expression in peritoneal washings of gastric cancer by RT-PCR method can significantly improve the detection rate of exfoliated cancer cells, which has a wide range of clinical value and significance.