Research Of Gastric Cancer Cells Exfoliated In The Abdominal Cavity

Objective:Our aim is to compare the difference of peritoneal cytological examination, tumor markers test, and Immunohistochemical that dete-cting the peritoneal cells in patients with gastric cancer and analyz-e the risk factors of gastric cancer recurrence.Materials and Methods:We selected 40 patients with Stage III gastric cancer that diagnosed through pathological diagnosis by the Department of gastrointestinal surgery of the Bethune first hospital of Ji Lin university from October2013 to March 2014. Meanwhile 25 patients with benign gastric ulcer or stomach were selected as the control group. The detection results of tumor markers(CA72-4、CEA) in serum and peritoneal lavage fluid were collected. Half of the sediment of Peritoneal lavage fluid was used to cytological detection, while remaining sediment for immunohistochemica-l detection of CEA and CA72-4. The patients were follow-up visited on every 6 months until 2 years after surgery.Results:5 out of 40 cases of peritoneal lavage cytology test results were positive with the rate of 12.5%. The sensitivity of CEA in the serum and peritoneal lavage fluid was 76.9% and 61.5% and the specificity was14.8% and 22.2%. The sensitivity and specificity of CA72-4 in the serum and peritoneal lavage fluid was much better than CEA with the rate of76.9% / 92.3% and 18.5% /48.1% respectively. The positive rates of CEA and CA72-4 immunohistochemical detection in patients with stage III gastric cancer were 47.5% and 42.5% which was the highest result in the three tests. Their sensitivity was 92.3%,and the specificity was 29.6%and 18.5% respectively.Up to 2 years after surgery, 13 out of the 40 stage III gastric cancer patients had recurred with the recurrence rate of 32.5%. The CEA and CA72-4 immunohistochemistry results, serum tumor markers CA72-4and CEA detection results, the detection results of shedding cells are the factors that affect the recurrence of gastric cancer after surgery by COX regression analysis. Through the multivariate COX regression analysis,we got the result that the factors influencing the recurrence of gastric cancer in the model were: CA72-4 immunohistochemical detection results, serum CA72-4 test results and the results of the detection of shedding cells.Conclusions:Tumor marker text and immunohistochemical examination can improve the detection rate of peritoneal cancer cells. And the immunohistochemistry results and tumor mark detection results in serum of CA72-4 and test results of peritoneal cytology can be used as predictors of postoperative recurrence of gastric cancer.