Changes of peritoneal free gastric cancer cells and its significance in patients after laparoscopic radical gastrectomy / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the safety and feasibility of laparoscopic radical gastrectomy on gastric cancer through comparison of peritoneal free gastric cancer cells detecting rates between laparoscopic and open radical gastrectomy.</p><p><b>METHODS</b>Sixty-three patients received laparoscopic gastrectomy and 61 patients received open gastrectomy between April 2006 and June 2008 were included in this study. The peritoneal lavage fluid in those patients before and after the operation was collected. The cancer cell cytology and carcinoembryonic antigen (CEA) mRNA were detected with those samples. The relationship between peritoneal free gastric cancer cells and the area of cancer-invaded serosa was also observed.</p><p><b>RESULTS</b>The positive rate of cytology in laparoscopic surgery was 25.4% in the peritoneal fluid after the operation, while it was 29.5% in the open surgery, there was no significant difference between the two groups (P > 0.05). The positive rate of CEA mRNA in the peritoneal fluid after the operation in the laparoscopic group was 41.3%, and was 40.3% in the open group (P > 0.05). The area of cancer-invaded serosa in patients with positive cytology before and after the operation in the laparoscopic group was (16.2 +/- 2.2) cm(2), and it was (17.6 +/- 3.0) cm(2) in their counterparts in the open surgery group, while it was (5.3 +/- 0.8) cm(2) in patients with negative cytology before and after the operation. The area of cancer-invaded serosa was positively correlated with the positive rate of cytology(R(2) = 0.874, P = 0.000).</p><p><b>CONCLUSIONS</b>Laparoscopic radical gastrectomy is not associated with a greater risk for peritoneal dissemination of cancer cells than the open technique.</p>