Study On HPA And SURVIVIN In Exfoliated Cancer Cells Of Peritoneal Lavage During Lapariscopic-assisted Gastrectomy

Purpose:1. To investigate the method of detecting peritoneal metastasis of gastric cancer.2. To explore the effect of laparoscopy-assisted radical gastrectomy on free cancer cells in peritoneal lavage fluid.Methods:Peritoneal lavage fluid from50cases of patients with gastric cancer was collected before and after laparoscopy-assisted radical gastrectomy. HPA and SURVIVIN expression in peritoneal lavage was detected by FCM before laparoscopy-assisted radical gastrectomy, and SURVIVIN expression in peritoneal lavage was detected by FCM after that. Meanwhile, the HE staining and peritoneal lavage cytology examination (PLC) were performed by TCT. Peritoneal lavage fluid from8cases of patients with benign gastric lesion were collected as negative control, and tissues of gastric carcinoma of50cases were collected as positive control.Results:The positive rates of HPA,SURVIVIN were52.0%,58.0%, and they are significantly higher than PLC (22.0%) in peritoneal washing of50patients with gastric cancer before laparoscopy-assisted radical gastrectomy. The positive rates of HPA and SURVIVIN combined were68.0%; The positive rates of HPA were related with depth of tumor invasion, degree of differentiation and TNM staging; The positive rates of SURVIVIN were related with depth of tumor invasion, degree of differentiation, lymph node metastasis and TNM staging. The positive rates of preoperative and postoperative SURVIVIN were58.0%(29/50) and66.0%(33/50), respectively, and there was no significant difference; The positive rates of preoperative and postoperative PLC were22.0%(11/50) and28.0%(14/50); The one PLC of Preoperative and postoperative was positive, while the FCM results were positive, too. None of8patients with benign disease were positive. In the50samples of tissue of gastric carcinoma, the positive rates of SURVIVIN was100.0%, and the HPA was94.0%.Conclusion:(1) HPA and SURVIVIN could be used as a detected indicator of malignant degree and prognosis.(2) Detection of HPA and SURVIVIN in peritoneal lavage fluid using FCM may become a method to predict the peritoneal metastasis.(3) Laparoscopy-assisted radical gastrectomy had not increase the intraperitoneal free cancer cells.