摘要
目的研究T细胞免疫球蛋白黏蛋白1(Tim-1)mRNA在胃癌患者腹腔灌洗液中的表达与其临床意义,探讨预测胃癌腹膜转移的方法。方法收集128例胃癌患者及12例良性病变患者的腹腔冲洗液作为对照组。采用实时定量RT-PCR法检测128例胃癌患者腹腔灌洗液中Tim-1mRNA的表达情况,术后随访半年至3年,根据超声,CT,MRI,或术中的诊断,明确腹膜转移的发生及时间。分析Tim-1mRNA与临床各病理参数关系及出现胃癌腹膜转移时间的关系,统计学分析。结果 128例患者中,57例(44.5%)术后出现腹膜转移,分为4组分析:术后半年出现腹膜转移23例(术后半年组),术后2～3年出现腹膜转移34例(术后2～3年组),术后无腹膜转移组71例及对照组12例。术后半年组Tim-1mRNA表达明显高于术后2～3年组,差异有统计学意义(P<0.05);这两组Tim-1mRNA表达又明显高于无腹膜转移组和对照组,差异有统计学意义(P<0.01);无腹膜转移组和对照组比较差异无统计学意义(P>0.05)。在肿瘤直径≥4cm、低分化、有淋巴结转移、浸润深度T3+T4期、TNM分期Ⅲ+Ⅳ期Tim-1mRNA为高表达,组间差异均有统计学意义(P<0.05)。结论 Tim-1mRNA在胃癌患者腹腔灌洗液中的表达与肿瘤的侵袭转移密切相关,可以作为预测胃癌腹膜转移的方法,Tim-1mRNA表达的高低对胃癌术后腹膜转移的早期和晚期预测有一定的临床意义,优于腹腔灌洗液脱落细胞学的检查。
Objective To evaluate the clinical significance of Tim-1 mRNA of peritoneal irrigation fluid during operation in predicting peritoneal metastasis of gastric cancer.Methods During radical operation for 128 patients with gastric cancer,we collected peritoneal irrigation fluid.After Tim-1mRNA levels were detected by realtime RT-PCR,the relationship was analyzed between Tim-1mRNA levels and clinical pathological parameters.All the patients were followed up from 0.5 to 3.0 years.Peritoneal metastasis of gastric cancer could be diagnosed using B ultrasound,CT,and MRI.Results Of the 128 patients,57（44.5%） suffered from peritoneal metastasis.The 128 patients were divided into 4 groups：0.5 year group：23 patients suffering from peritoneal metastasis after 0.5 year;2-3 years group：34 patients suffering from peritoneal metastasis after 2-3 years;and non-metastasis group：71 patients with non-peritoneal metastasis.Twelve patients served as a control group.Tim-1 mRNA levels of the 0.5 year group was significantly higher than that of the 2-3 years group（P0.05）.The levels of the two groups were significantly higher than those of the non-recurrence group and control group（P0.01）.There was no significantly difference between the non-recurrence group and control group（P0.05）.We found that Tim-1mRNA levels were higher in the following conditions：dimension ≥ cm and differentiation,lymph node metastasis,invasion T3＋T4,stage Ⅲ＋Ⅳ.There was a significant difference between the groups（P0.05）.Conclusions Tim-1mRNA level in peritoneal irrigation fluid is of great value in predicting peritoneal metastasis,and the detection of the level is better than peritoneal lavage cytology.
出处
《中华普外科手术学杂志（电子版）》
2011年第4期21-24,34,共5页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
湖北省自然科学基金资助项目(2005ABA121
2008CDB185)
作者简介
通讯作者：孙华文，电子邮箱：sunhuawenmail@gmail．com
