Kienle Peter, Koch Moritz
Department of Surgery, University of Heidelberg, INF 110, D-69120 Heidelberg, Germany.
Dig Surg. 2002;19(6):453-8. doi: 10.1159/000067609.
Tumor progression after curative resection of gastrointestinal cancer is probably caused by disseminated tumor cells that can be detected in different body compartments, e.g. the peritoneum. The clinical importance and prognostic significance of gross peritoneal metastasis is well known whereas the prognostic relevance of disseminated tumor cells in the peritoneum of patients with gastrointestinal cancer is still unclear. Disseminated tumor cells in the peritoneal cavity are generally detected by cytology, immunohistochemistry or polymerase chain reaction-based molecular methods. A consensus on the most adequate detection method has not yet been found making the comparison of different data difficult. The prognostic relevance of tumor cell dissemination has, at least in part, been shown for gastric, pancreatic and colon cancer, and the prognostic data regarding gastric cancer are most convincing. Peritoneal "micrometastases" are obviously not equivalent to distant metastases as the evidence for their prognostic significance is clearly less than that for gross peritoneal metastases. This article gives a critical review of the detection and prognostic significance of disseminated tumor cells in the peritoneum of patients with gastrointestinal cancer.
胃肠道癌根治性切除术后的肿瘤进展可能是由可在不同身体腔隙（如腹膜）中检测到的播散性肿瘤细胞引起的。肉眼可见的腹膜转移的临床重要性和预后意义是众所周知的，而胃肠道癌患者腹膜中播散性肿瘤细胞的预后相关性仍不清楚。腹腔内的播散性肿瘤细胞通常通过细胞学、免疫组织化学或基于聚合酶链反应的分子方法进行检测。尚未找到关于最适当检测方法的共识，这使得不同数据的比较变得困难。肿瘤细胞播散的预后相关性至少在一定程度上已在胃癌、胰腺癌和结肠癌中得到证实，关于胃癌的预后数据最具说服力。腹膜“微转移”显然不等同于远处转移，因为其预后意义的证据明显少于肉眼可见的腹膜转移。本文对胃肠道癌患者腹膜中播散性肿瘤细胞的检测及其预后意义进行了批判性综述。
