[结直肠手术后阳性腹腔灌洗细胞学检查的预后价值及腹膜播散的预防]

[The prognostic value of positive peritoneal lavage cytology and the prevention of peritoneal dissemination after colorectal surgery].

作者信息

Tanida Tsukasa, Noura Shingo, Ohue Masayuki, Seki Yousuke, Gotoh Kunihito, Motoori Masaaki, Kishi Kentarou, Takachi Kou, Yamada Terumasa, Miyashiro Isao, Ohigashi Hiroaki, Yano Masahiko, Ishikawa Osamu, Imaoka Shingi, Murata Kohei, Kameyama Masao

机构信息

Dept. of Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease.

出版信息

Gan To Kagaku Ryoho. 2007 Nov;34(12):1937-9.

PMID:18219858

Abstract

Peritoneal washing cytology during surgery was done in 745 patients with colorectal cancer. The positive washing cytology rate was 49/745 (6.6%). The peritoneal recurrence rates were 12/22 (54.5%) and 8/682 (1.3%) among patients with positive and negative peritoneal washing, respectively (p < 0.0001). The 5-year survival rate is 89.4% of the patients with positive cytology and 38.2% with negative cytology. The patients with positive cytology have a significantly lower survival rate than the negative one (p < 0.0001). Eleven patients of the positive cytology received intraperitoneal administration of MMC. Peritoneal dissemination occurred in 3/11 (27.3%) of the MMC treated group and 9/11 (81.8%) in the untreated group (p = 0.030). Our results indicated that intraperitoneal administration of MMC was an effective method of preventing peritoneal dissemination after resection of colorectal cancer.

摘要

对745例结直肠癌患者在手术期间进行了腹腔冲洗细胞学检查。冲洗细胞学阳性率为49/745（6.6%）。腹腔冲洗阳性和阴性患者的腹膜复发率分别为12/22（54.5%）和8/682（1.3%）（p<0.0001）。细胞学阳性患者的5年生存率为89.4%，细胞学阴性患者为38.2%。细胞学阳性患者的生存率显著低于阴性患者（p<0.0001）。11例细胞学阳性患者接受了腹腔内丝裂霉素（MMC）给药。MMC治疗组3/11（27.3%）发生腹膜播散，未治疗组9/11（81.8%）发生腹膜播散（p=0.030）。我们的结果表明，腹腔内给予MMC是预防结直肠癌切除术后腹膜播散的有效方法。