Emoto Shigenobu, Kitayama Joji, Yamaguchi Hironori, Ishigami Hironori, Kaisaki Shoichi, Nagawa Hirokazu
Department of Surgery, Division of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
Case Rep Oncol. 2010 Oct 1;3(3):344-348. doi: 10.1159/000321262.
Oxygen is one of the most important environmental factors for tumor development. In this study, we examined pO(2) in malignant ascites in patients with peritoneal carcinomatosis. METHODS: In 21 patients with peritoneal dissemination of gastric cancer, ascitic fluid was collected and its pH, pCO(2) and pO(2) were determined using a blood gas analyzer. RESULTS: In 21 patients, pH of malignant ascites was significantly lower than that of arterial blood (7.39 ± 0.07, 7.44 ± 0.02, p < 0.05). Accordingly, pCO(2) tended to be higher in ascites than in arterial blood. Unexpectedly, pO(2) in malignant ascites showed relatively high values (90.4 ± 27.72 mm Hg), which were mostly the same as those of arterial blood (97.09 ± 10.33 mm Hg, p = 0.858). Even in 19 patients whose samples were collected at bedside in room air, pO(2) of malignant ascites was 85.94 ± 23.94 mm Hg, which was patently higher than that in venous blood or in solid tumor tissues. CONCLUSION: Since the oxygen level critically affects the sensitivity of tumor cells to chemotherapeutic agents through metabolic transformation, the oxygenic condition in the peritoneal cavity may be beneficial for the progression of peritoneal metastasis, and also clinically important in considering the efficacy of chemotherapy.
氧气是肿瘤发展最重要的环境因素之一。在本研究中,我们检测了腹膜癌患者恶性腹水中的氧分压(pO₂)。方法:收集21例胃癌腹膜转移患者的腹水,使用血气分析仪测定其pH值、二氧化碳分压(pCO₂)和氧分压。结果:21例患者中,恶性腹水的pH值显著低于动脉血(分别为7.39±0.07、7.44±0.02,p<0.05)。相应地,腹水的pCO₂往往高于动脉血。出乎意料的是,恶性腹水中的pO₂显示出相对较高的值(90.4±27.72mmHg),与动脉血的值(97.09±10.33mmHg,p = 0.858)基本相同。即使在19例在室内空气中于床边采集样本的患者中,恶性腹水的pO₂为85.94±23.94mmHg,明显高于静脉血或实体瘤组织中的pO₂。结论:由于氧水平通过代谢转化严重影响肿瘤细胞对化疗药物的敏感性,腹腔内的氧状况可能有利于腹膜转移的进展,并且在考虑化疗疗效时在临床上也很重要。