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AIM:To investigate the influence of CO2-insufflation pressure on adhesion,invasion and metastatic potential of colon cancer cells based on adhesion molecules expression.METHODS:With an in vitro artificial pneumoperitoneum model,SW1116 human colon carcinoma cells were exposed to CO2-insufflation in 5 different pressure groups:6 mmHg,9 mmHg,12 mmHg,15 mmHg and control group,respectively for 1 h.Expression of E-cadherin,ICAM-1,CD44 and E-selectin was measured at 0,12,24,48 and 72 h after CO2-insufflation using flow cytometry.The adhesion and invasion capacity of SW1116 cells before and after exposure to CO2-insufflation was detected by cell adhesion/invasion assay in vitro.Each group of cells was injected intraperitoneally into 16 BALB/C mice.The number of visible abdominal cavity tumor nodules,visceral metastases metastases and survival of the mice were recorded in each group.RESULTS:The expression of E-cadherin,ICAM-1,CD44 and E-selectin in SW1116 cells were changed significantly following exposure to CO2 insufflation at different pressures (P<0.05).The expression of E-cadherin,CD44 and ICAM-1 decreased with increasing CO2-insufflation pressure.The adhesive/invasive cells also decreased gradually with increasing pressure as determined by the adhesion/invasion assay.In animal experiments,the number of abdominal cavity tumor nodules in the 15 mmHg group was also significantly lower than that in the 6 mmHg group (29.7 ?à 9.91 vs 41.7 ?à 14.90,P=0.046).However,the survival in each group was not statistically different.CONCLUSION:CO2-insufflation induced a temporary change in the adhesion and invasion capacity of cancer cells in vitro.Higher CO2-insufflation pressure inhibited adhesion,invasion and metastatic potential in vitro and in vivo,which was associated with reduced expression of adhesion molecules.