Research of peritoneal micrometastasis in patients with gastric carcinoma / 中国现代普通外科进展

ABSTRACT

Objective:To investigate the related factors and clinical significance of peritoneal micrometastasis in patients with gastric carcinoma,providing theoretical basis for resection range。Methods:CK19,CK20 immunohistochemistry were performed on 62 patients' tissues taken from anterior lobe of transverse mesocolon,posterior wall of omental bursa,pancreatic capsule and rectovesical pouch or Douglas pouch during the operations,compared with HE staining and peritoneal lavage cytology(PLC).Results:No metastasis was found by HE staining.Peritoneal micrometastasis were found in 27 cases out of 62 by immunohistochemistry,and its positive rate was 43.55%,obviously higher than PLC(14.52%).The peritoneal micrometastasis of gastric carcinoma had relations with diameter of tumor,depth of infiltration,clinical stage,lymph node metastasis(P0.05).Conclusion:Immunohistochemistric measure of CK 19 and CK20 can be effective to detect the micrometastasis of gastric carcinoma,which is helpful to guide clinical staging and useful to provide evidence for accurate selection of operation and postoperative treatment.Routine detection of peritoneal micrometastasis should be taken in patients of advanced gastric carcinoma,especially with a large size of serosa invasion.Multiple spots sampling is helpful to improve the detection rate.Anterior lobe of transverse mesocolon and pancreatic capsule should be peeled,and radical resection of omental bursa should be considered as routine operation in these patients.