Nakao A, Oshima K, Takeda S, Kaneko T, Kanazumi N, Inoue S, Nomoto S, Kawase Y, Kasuya H
Department of Surgery II, Nagoya University School of Medicine, Japan.
Hepatogastroenterology. 1999 Sep-Oct;46(29):2974-7.
BACKGROUND/AIMS: Peritoneal washings from patients with pancreatic cancer demonstrate malignant cells in 0-58% of patients. But the significance of their potential for implantation and growth after radical surgery has not been clarified.
Peritoneal washings were collected from 74 consecutive pancreatic cancer patients during a 5-year period and studied by conventional staining and immunocytochemical staining using anti-CEA and anti-CA 19-9. Fifty of the 74 patients were resectable and the others were nonresectable.
Seven out of 8 patients with macroscopic peritoneal metastasis were positive in conventional staining, but all 8 patients were positive in immunocytochemical staining. Five of the 66 (8%) patients without macroscopic peritoneal metastasis were positive in conventional staining, but the positive rate increased to 14 of 66 (22%) in immunocytochemical staining. There was no statistically significant difference in post-operative cumulative survival rate between the 13 positive cytology patients and 37 negative cytology patients without macroscopic peritoneal metastasis.
The positive rate of peritoneal washings cytology was increased in this study by the use of immunocytochemical staining in addition to conventional staining. No statistically significant difference in post-operative cumulative survival rate between positive cytology patients and negative cytology patients without macroscopic peritoneal metastasis was observed.
背景/目的:胰腺癌患者的腹腔冲洗液显示,0-58%的患者存在恶性细胞。但其在根治性手术后植入和生长的可能性的意义尚未明确。
在5年期间,连续收集74例胰腺癌患者的腹腔冲洗液,并采用常规染色以及使用抗CEA和抗CA 19-9的免疫细胞化学染色进行研究。74例患者中50例可切除,其余不可切除。
8例有肉眼可见腹膜转移的患者中,7例常规染色呈阳性,但所有8例免疫细胞化学染色均呈阳性。66例无肉眼可见腹膜转移的患者中,5例(8%)常规染色呈阳性,但免疫细胞化学染色阳性率增至66例中的14例(22%)。13例细胞学阳性患者与37例无肉眼可见腹膜转移的细胞学阴性患者术后累积生存率无统计学显著差异。
本研究中,除常规染色外,使用免疫细胞化学染色可提高腹腔冲洗液细胞学的阳性率。在无肉眼可见腹膜转移的细胞学阳性患者与细胞学阴性患者之间,未观察到术后累积生存率有统计学显著差异。