摘要
目的研究胃癌增殖细胞核抗原(proliferatingcellnuclearantigen,PCNA)表达与腹腔灌洗液端粒酶活性及腹膜转移的相关性,并比较腹腔灌洗液中端粒酶活性和细胞学检测游离癌细胞预测腹膜转移的应用价值。方法应用免疫组化SP法检测60例胃癌患者胃癌组织中PCNA表达,PCRTRAPELISA法检测腹腔灌洗液中端粒酶活性,同时行腹腔灌洗液脱落细胞学(peritoneallavagecytology,PLC)检测;并分析其与相关临床病理因素的关系。结果胃癌患者腹腔灌洗液中端粒酶活性的阳性率为41.7%;与浆膜侵犯、组织学类型、浸润深度、浆膜受累面积及腹膜转移密切相关,并随着浸润深度及浆膜受累面积的增加而升高(P<0.05)。PLC检测阳性率为25.0%;在伴肉眼可见腹膜转移灶(P1～3)者明显增高,也随着浸润深度及浆膜受累面积的增加而升高。两种方法检测的阳性率总体上差异无统计学意义,但在未分化型癌、pT4、伴肉眼可见腹膜转移灶(P1～3)者端粒酶活性阳性率明显高于PLC。PCNA增殖指数(PI)在腹腔灌洗液端粒酶活性表达阳性者明显高于表达阴性者,伴肉眼可见腹膜转移灶(P1～3)者明显高于无肉眼可见腹膜转移灶(P0)者,浆膜受侵者明显高于浆膜未受侵者(P均<0.05)。结论两种方法均适用于胃癌腹腔脱落癌细胞的诊断或腹膜转移的预测,端粒酶活性检测微量癌细胞的灵敏度优于PLC法检测;胃癌端粒酶活性与恶性增殖活性密切相关;胃癌高增殖活性是浆膜受侵及腹膜转移的重要原因。
Objective To investigate the expression of PCNA in gastric cancer and its relationship with telomerase activity of peritoneal washings and peritoneal dissemination, and to compare the efficacy of telomerase activity and cytology of peritoneal washings for prediction of peritoneal metastasis of gastric cancer. Methods Telomeric repeated amplification protocol （TRAP）-enzyme-linked immunosorbent assay （ELISA） was performed to measure the telomerase activity of peritoneal washings collected from 60 patients with gastric cancer. Exfoliate cytologic analysis of the corresponding samples was used for comparison. Expression of PCNA was measured with immunohistochemical staining. Their relationship with clinicopathologic features were evaluated. Results The positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was 41. 7% ,which well related to serosal invasion, histology types, depth of infiltration and peritoneal metastasis of gastric cancer. The positive rate of telomerase activity increased with the increased depth of infiltration and serosal involvement areas （P〈0.05）. The positive rate of exfoliative cytology was 25.0% , which was obviously high in the group with macroscopic peritoneal metastasis （ the group of P1-3 ）. The positive rate of exfoliative cytology also increased with the increased depth of infiltration and serosal involvement areas （P〈0.05）. Although the positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was not significantly higher than that of exfolia tive cytology in general, it was significantly higher than that of exfoliative cytology in the group of pT1, P1-3 and undifferentiated type. The PCNA proliferation index （P1） of positive telomerase activity group was significantly higher than that of negative , The PCNA Pl was significantly higher in the group of P1-3 and serosal invasion than that of P1-3 and without serosal invasion. Conclusion To detect telomerase activity in
出处
《中国普外基础与临床杂志》
CAS
2006年第1期25-28,共4页
Chinese Journal of Bases and Clinics In General Surgery
基金
国家自然科学基金资助项目(编号:30370639)
关键词
胃癌
端粒酶活性
腹腔灌洗
腹膜转移
增殖细胞核抗原
Gastric cancer Telomerase activity Peritoneal lavage Peritoneal metastasis Proliferating cell nuclear antigen
