Korenaga D, Funahashi S, Yano K, Maekawa S, Ikeda T, Sugimachi K
Department of Surgery, Fukuoka (Japan) City Hospital.
Arch Surg. 1995 Jul;130(7):769-73. doi: 10.1001/archsurg.1995.01430070091018.
To predict disseminated microscopic foci or occult micrometastases in the peritoneal cavity in patients with gastric cancer.
Randomly selected patients with gastric cancer had peritoneal washings performed at the beginning of laparotomy.
Thirty-nine patients with gastric carcinoma and 10 patients with other benign disease as a control group.
Inpatients in a surgical department.
The concentration of collagen type IV in the irrigated peritoneal fluid was measured radioimmunologically. Intraoperative peritoneal cytologic examination and measurements of carcinoembryonic antigen (CEA) levels were also performed.
Results of the quantitative analyses of the collagen type IV concentrations as related to the clinicopathological characteristics and comparison of these results with regard to those of the peritoneal cytologic examination and CEA and collagen type IV levels.
There were eight patients with elevated collagen type IV concentrations. They had carcinomas with serosal invasion (pT3 and pT4) and metastatic spread (pN2, M1). Patients with clinically evident peritoneal disseminated metastases had significantly higher collagen type IV concentrations compared with those without metastases. The collagen type IV levels were more sensitive than peritoneal cytologic examination or CEA values in detecting disseminated metastases. There was an early peritoneal recurrence in the form of ovarian metastases in one patient with negative cytologic results and an elevated collagen type IV level. Linear regression analysis showed a statistically significant correlation between the collagen type IV and CEA levels.
Quantitative detection of abnormal collagen type IV levels may be useful for predicting the presence of disseminated metastases in patients with gastric cancer.
预测胃癌患者腹腔内播散的微小病灶或隐匿性微转移。
随机选取的胃癌患者在剖腹手术开始时进行腹腔冲洗。
39例胃癌患者和10例其他良性疾病患者作为对照组。
外科住院患者。
采用放射免疫法测定冲洗后腹腔液中IV型胶原的浓度。术中还进行了腹腔细胞学检查和癌胚抗原（CEA）水平测定。
IV型胶原浓度定量分析结果与临床病理特征的关系，以及将这些结果与腹腔细胞学检查、CEA和IV型胶原水平的结果进行比较。
有8例患者IV型胶原浓度升高。他们患有浆膜侵犯（pT3和pT4）和转移扩散（pN2，M1）的癌症。与无转移的患者相比，有临床明显腹腔播散转移的患者IV型胶原浓度显著更高。在检测播散转移方面，IV型胶原水平比腹腔细胞学检查或CEA值更敏感。1例细胞学检查结果为阴性但IV型胶原水平升高的患者出现了卵巢转移形式的早期腹腔复发。线性回归分析显示IV型胶原与CEA水平之间存在统计学显著相关性。
定量检测异常的IV型胶原水平可能有助于预测胃癌患者是否存在播散转移。
