RESUMO
@#[Abstract] Objective: To investigate the expression and clinical significance of CEAmRNAin peritoneal lavage fluid for patients with gastric cancer after radical surgery. Methods: The clinical data of 139 gastric cancer patients, who underwent peritoneal lavage CEA mRNA detection after radical resection in the Comprehensive Cancer Centre of Drum Tower Hospital from January 2013 to December 2017 were retrospectively analyzed. Routine post-operative follow-up was conducted in all patients. The expression of CEA mRNA in peritoneal lavage fluid after radical resection of 139 gastric cancer patients was detected by RT-PCR. Chi-square test analysis was used to study the relationship between the expression of CEA mRNA in peritoneal lavage fluid and basic clinical features, histopathological data, hematological indicators and the recurrence pattern of GC patients. Logistic univariate and multivariate regression analyses were used to screen the influential factors affecting CEA mRNA expression. Results: CEA mRNA was positive in 44 (31.7%) of 139 patients. Analysis showed that there was no significant correlation between CEA mRNA expression and sex, age, pathological grade, Lauren type, HER2, EGFR, VEGFR and Ki67 (all P>0.05), but there was significant correlation between CEA mRNA expression and pathological type, vascular invasion, local invasion depth, lymph node metastasis and clinical AJCC stage (all P<0.05). The peritoneal recurrence rate of patients with positive CEA mRNA expression was significantly higher than that of patients with negative expression (P=0.012). Logistic univariate regression analysis showed that signet ring cell carcinoma (P=0.04, HR=2.810， 95% CI: 1.050-7.520), T stage (P=0.016，HR=6.329, 95% CI: 1.417-28.264), N stage (P=0.022，HR=3.068，95% CI: 1.172-8.027), AJCC stage (P=0.016，HR= 3.971, 95% CI: 1.295-12.173), nerve invasion (P=0.002, HR=6.738, 95% CI: 1.995-22.757) and vascular invasion (P<0.001, HR= 16.36, 95% CI: 3.85-69.512) were risk factors for positive CEA mRNA expression in peritoneal lavage fluid of patients with gastric cancer. Logistic multivariate regression analysis showed that vascular invasion (P<0.001, HR=21.314，95% CI: 4.21-107.907) was an independent risk factor for positive CEAexpression in peritoneal lavage fluid of gastric cancer patients. Conclusion: Gastric cancer patients with positive CEA mRNA in peritoneal lavage fluid have higher risk of peritoneal recurrence or metastasis and poorer prognosis. So, more aggressive anti-tumor treatments including local abdominal cavity treatment should be considered.
RESUMO
Objective To establish a more sensitive method to detect free cancer cells in peritoneal washings of gastric cancer cases during surgery. Methods The CEAmRNA levels in peritoneal washings in 65 cases of gastric cancer were detected by Real-time RT-PCR. PLC was applied simultaneously to detect free cancer cells. Negative controls included the peritoneal washings from 5 cases of benign gastric diseases and the blood samples from 5 cases of healthy adult volunteers. Results (1)CEAmRNA was not found in peritoneal washings in benign gastric diseases and in blood of healthy adult volunteers. (2)The positive percentage of free cancer cells detected by Real-time RT-PCR was 47.7%, while PLC′s was only 12.3%.(3)The positive rate of CEAmRNA showed a significant difference between gastric cancer with serosal invasion and without serosa invasion groups, between peritoneal metastasis group and no peritoneal metastasis groups, and also between stages I+II and III+IV diseases(all P