Kristensen Annette Torgunrud, Wiig Johan N, Larsen Stein G, Giercksky Karl-Erik, Ekstrøm Per O
Section for Surgical Oncology, Rikshospitalet-Radiumhospitalet Medical Center, Montebello, Oslo, Norway.
BMC Cancer. 2008 Jul 27;8:213. doi: 10.1186/1471-2407-8-213.
After total mesorectal excision (TME) for rectal cancer around 10% of patients develops local recurrences within the pelvis. One reason for recurrence might be spillage of cancer cells during surgery. This pilot study was conducted to investigate the incidence of remnant cancer cells in pelvic lavage after resection of rectal cancer. DNA from cells obtained by lavage, were analysed by denaturing capillary electrophoresis with respect to mutations in hotspots of the k-ras gene, which are frequently mutated in colorectal cancer.
Of the 237 rectal cancer patients analyzed, 19 had positive lavage fluid. There was a significant survival difference (p = 0.006) between patients with k-ras positive and negative lavage fluid.
Patients with k-ras mutated cells in the lavage immediately after surgery have a reduced life expectation. Detection of exfoliated cells in the abdominal cavity may be a useful diagnostic tool to improve the staging and eventually characterize patients who may benefit from aggressive multimodal treatment of rectal cancer.
直肠癌全直肠系膜切除（TME）术后，约10%的患者会出现盆腔内局部复发。复发的一个原因可能是手术过程中癌细胞的溢出。本前瞻性研究旨在调查直肠癌切除术后盆腔灌洗中残留癌细胞的发生率。通过变性毛细管电泳分析灌洗获得的细胞DNA，检测结直肠癌中常见突变的k-ras基因热点突变。
在分析的237例直肠癌患者中，19例灌洗液呈阳性。k-ras灌洗液阳性和阴性的患者之间存在显著的生存差异（p = 0.006）。
术后立即灌洗中存在k-ras突变细胞的患者预期寿命缩短。检测腹腔内脱落细胞可能是一种有用的诊断工具，有助于改善分期，并最终确定可能从积极的直肠癌多模式治疗中获益的患者特征。
