目的研究胃癌增殖細胞核抗原(proliferating cell nuclear antigen，PCNA)表達與腹腔灌洗液端粒酶活性及腹膜轉(zhuǎn)移的相關(guān)性，并比較腹腔灌洗液中端粒酶活性和細胞學(xué)檢測游離癌細胞預(yù)測腹膜轉(zhuǎn)移的應(yīng)用價值。
方法應(yīng)用免疫組化SP法檢測60例胃癌患者胃癌組織中PCNA表達,PCRTRAPELISA法檢測腹腔灌洗液中端粒酶活性,同時行腹腔灌洗液脫落細胞學(xué)(peritoneal lavage cytology,PLC)檢測； 并分析其與相關(guān)臨床病理因素的關(guān)系。
結(jié)果胃癌患者腹腔灌洗液中端粒酶活性的陽性率為41.7%； 與漿膜侵犯、組織學(xué)類型、浸潤深度、漿膜受累面積及腹膜轉(zhuǎn)移密切相關(guān)，并隨著浸潤深度及漿膜受累面積的增加而升高(P＜0.05)。PLC檢測陽性率為25.0%； 在伴肉眼可見腹膜轉(zhuǎn)移灶(P1～3)者明顯增高，也隨著浸潤深度及漿膜受累面積的增加而升高。兩種方法檢測的陽性率總體上差異無統(tǒng)計學(xué)意義，但在未分化型癌、pT4、伴肉眼可見腹膜轉(zhuǎn)移灶(P1～3)者端粒酶活性陽性率明顯高于PLC。PCNA增殖指數(shù)（PI）在腹腔灌洗液端粒酶活性表達陽性者明顯高于表達陰性者，伴肉眼可見腹膜轉(zhuǎn)移灶(P1～3)者明顯高于無肉眼可見腹膜轉(zhuǎn)移灶（P0）者，漿膜受侵者明顯高于漿膜未受侵者（P均＜0.05）。
結(jié)論兩種方法均適用于胃癌腹腔脫落癌細胞的診斷或腹膜轉(zhuǎn)移的預(yù)測，端粒酶活性檢測微量癌細胞的靈敏度優(yōu)于PLC法檢測； 胃癌端粒酶活性與惡性增殖活性密切相關(guān)； 胃癌高增殖活性是漿膜受侵及腹膜轉(zhuǎn)移的重要原因。
引用本文： 達明緒 ,趙紫罡,羅婷,張明鳴,伍曉汀. 胃癌細胞增殖與腹腔灌洗液中端粒酶活性及腹膜轉(zhuǎn)移的相關(guān)性研究. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(1): 25-28. doi: 復(fù)制
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