| In recent years, malignant neoplasms have become the prime death cause of Chinese citizens. Gastric carcinoma is a main kind of gastrointestinal malignant neoplasm which gravely threatens people's health, influences patients'living quality and brings heavy economic burden to their families and the society. Many patients with gastric carcinoma are diagnosed when their disease have proceeded to middle or advanced stage. At present, the primary therapy against gastric carcinoma remains mainly dependent on radical operation, supplemented after operation with comprehensive treatment methods such as chemotherapy, radiotherapy and immunotherapy. However, there are still many problems demanding prompt solution. Some postoperative patients have relapse recurrence or metastasis, which lacks effective therapy; some patients with late cancer can't have excision because of deep gastric carcinoma invasion; regular chemotherapy and radiotherapy after operation harms patients' immunologic function.Micrometastasis of gastric carcinoma has much to do with relapse recurrence, metastasis and prognosis of this disease. As progress has been made in molecular biotechnology, detecting CK20mRNA of peripheral blood of these patients with RT-PCR can effectively help judge their micrometastasis and prognosis. As a new method of tumor immunotherapy, cellular immunotherapy has significant complementary action with operation, chemotherapy and radiotherapy and meanwhile has no obvious toxicity or negative effect on hematopoiesis, immune system and main organs'function. The clinical application of combined cellular therapy with both autologous DC (dendritic cell) and CIK (cytokine-induced killer cell) on malignant neoplasms has begun and appeared in researches and reports at home and abroad. However, this therapy is mainly used against malignant neoplasms in blood system, kidney, liver and ovary etc. Using it against gastric carcinoma is still in the beginning stage at present. Through the clinical application of cellular immunotherapy with autologous DC,CIK cells on postoperative patients with gastric carcinoma and detecting CK20mRNA of Peripheral blood with RT-PCR, the purpose of this experiment is to explore the effect of cellular immunotherapy on micrometastasis to peripheral blood, and the possibility of using CK20mRNA detection as prognosis judgment, so as to guide the clinical therapy in future.44 patients with gastric carcinoma and 20 healthy people, who were surveyed in this experiment, received CK20mRNA detection of their peripheral blood. All the patients with gastric carcinoma had had radical operations. After postoperative patients received cellular immunotherapy, We once again detected their CK20mRNA indicators and made close follow-up survey to observe CK20mRNA differences before and after therapy and their partial recurrence and rate of distant metastasis etc.Survey results showed there were significant differences in CK20mRNA indicators of peripheral blood between healthy people and patients with gastric carcinoma(P<0.01). Sex, age, histodifferenciation and tumor size's influence on CK20mRNA detection results had no meaning for statistics, while pathological changes in gastric antrum and pylorus, depth of invasion, metastasis to lymph node and pathology stage had some impact on the detection results(P<0.05).Postoperative patients' CK20mRNA indicators were quite different between before and after cellular therapy(P<0.01). The median disease-free survival time of patients with positive CK20mRNA of peripheral blood after operation was different from those with negative CK20mRNA(P<0.05). The differences of postoperative recurrence rate between patients with positive CK20mRNA and those with negative CK20mRNA had no meaning for statistics (P>0.05). Hepatic metastasis rate of postoperative patients with positive CK20mRNA was higher than those with negative CK20mRNA (P<0.05)Conclusion:The CK20mRNA indicator of peripheral blood of postoperative patients with gastric carcinoma can effectively reflect micrometastasis of peripheral blood and applying RT-PCR technology to detect CK20mRNA has some advantage. The CK20mRNA detection results have nothing to do with sex, age, histodifferenciation or tumor size, but relate to location of pathological changes, depth of invasion, metastasis to lymph node and pathology stage. Cellular immunotherapy with autologous DC and CIK can effectively cut down positive CK20mRNA of peripheral blood of postoperative patients with gastric carcinoma and play a positive role in reducing hepatic metastasis. However, it is not so effective in reducing recurrence rate. The follow-up survey shows the disease-free survival time of postoperative patients with positive CK20mRNA of peripheral blood is slightly different from those with negative CK20mRNA.
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