端口组成对肿瘤细胞黏附的影响：一种体内模型

Brundell Simeon, Tsopelas Chris, Chatterton Barry, Touloumtzoglou Joanna, Blefari Cristina, Hewett Peter J

University of Adelaide, Division of Surgery, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.

Dis Colon Rectum. 2003 May;46(5):637-42. doi: 10.1007/s10350-004-6624-z.

INTRODUCTION

We have reported previously on an in vitro model to examine tumor cell adherence to metal and plastic laparoscopic ports and to port sites through which they had been passed. This demonstrated that increased numbers of tumor cells were found both on metal ports compared with plastic ports and on the port sites through which metal ports had passed. In this study, the in vivo adherence of such cells to ports and port sites was investigated.

METHODS

LIM 1215 tumor cells were injected under direct vision into the pelvises of 16 30-kg female pigs (range, 15-70 x 106 cells). A total of 12 ports were inserted through each anterior abdominal wall (6 metal and 6 plastic), and these were either left in situ for 30 minutes (nondisplaced) or were removed twice and replaced through the original wound (displaced).

RESULTS

Increasing the tumor cell inoculum resulted in increased deposition of tumor cells on both ports (P = 0.002) and on the port sites (P = 0.017). Significantly more tumor cells adhered to metal ports than to plastic ports (P = 0.04), although this failed to reach significance for the sites through which metal ports had been passed (P = 0.066). Although displacement of ports did not increase the number of tumor cells that adhered to ports (P = 0.45), this did result in more tumor cells being deposited on the port sites (P = 0.01).

CONCLUSIONS

These data suggest that minimizing the number of tumor cells within the abdominal cavity, using plastic ports, and securing ports to prevent inadvertent displacement would be expected to reduce the number of tumor cells deposited in port sites during operative laparoscopy. This may be beneficial in reducing the incidence of port-site metastases after laparoscopic surgery for gastrointestinal malignancies.

引言

我们之前报道过一种体外模型，用于研究肿瘤细胞对金属和塑料腹腔镜端口以及它们所穿过的端口部位的粘附情况。这表明，与塑料端口相比，在金属端口上发现的肿瘤细胞数量增加，并且在金属端口所穿过的端口部位也发现了更多肿瘤细胞。在本研究中，对这些细胞在体内对端口和端口部位的粘附情况进行了研究。

方法

在直视下将 LIM 1215 肿瘤细胞注入 16 头体重 30 千克的雌性猪（范围为 15 - 70×10⁶ 个细胞）的盆腔内。通过每个前腹壁插入总共 12 个端口（6 个金属端口和 6 个塑料端口），这些端口要么原位保留 30 分钟（未移位），要么两次取出并通过原伤口重新插入（移位）。

结果

增加肿瘤细胞接种量导致肿瘤细胞在端口（P = 0.002）和端口部位（P = 0.017）的沉积增加。粘附在金属端口上的肿瘤细胞明显多于塑料端口（P = 0.04），尽管在金属端口所穿过的部位这一差异未达到显著水平（P = 0.066）。尽管端口移位并未增加粘附在端口上的肿瘤细胞数量（P = 0.45），但这确实导致更多肿瘤细胞沉积在端口部位（P = 0.01）。