| Objective: Peritoneal metastasis of gastric cancer is the most common mode of metastasis of gastric cancer and the main cause of death in patients with gastric cancer.In fact,preoperative diagnosis of gastric cancer patients with peritoneal metastases is difficult.Preoperative imaging examination is one of the important detection methods.It often has large metastases on the abdominal wall.The peritoneal metastasis is found later.At that time,the patient has had ascites.Other related symptoms such as bloating.In recent years,it has been reported that preoperative CA125 and ascites in patients with gastric cancer have high value in clinical prediction of gastric cancer peritoneal metastasis.This retrospective study mainly used CA125 and ascites for combined detection to evaluate the peritoneal metastasis of gastric cancer and to explore the significance of surgery and postoperative chemotherapy in patients with gastric cancer peritoneal metastasis.Method: This study retrospectively analyzed 921 patients who underwent gastric cancer surgery at the Cancer Hospital of China Medical University(and Liaoning Cancer Hospital)from January 2013 to December 2017.The preoperative serum tumor marker levels and other relevant clinicopathological data were collected.To analyze and explore the correlation between preoperative tumor marker levels and other clinicopathological data and gastric cancer peritoneal metastasis.A retrospective analysis of 89 cases of gastric cancer with peritoneal metastasis was performed.The preoperative clinical and pathological data,the mode of metastasis,the choice of surgical methods,and the postoperative treatment measures were collected.Result: The clinicopathological data related to peritoneal metastasis of gastric cancer were ascites(P≦0.001),tumor infiltrating serosa(P≦0.001),lymph node metastasis(P≦0.001),and tumor markers associated with gastric cancer peritoneal metastasis.The substances were CA125(P≦0.001)and CA72-4(P=0.009).Removal of confounding factors showed CA125(OR = 12.281,95% confidence interval 0.539-40410,P = 0.006),ascites(OR = 9.489,95% confidence interval 1.655-54.760)was an independent risk factor for gastric cancer peritoneal metastasis.Univariate analysis of the clinician’s clinical pathology showed that surgical methods,chemotherapy,peritoneal metastasis,and Borrmann classification had significant effects on the prognosis of gastric cancer with peritoneal metastasis.Conclusion: Preoperative CA12-5 and ascites are of high value in predicting the peritoneal metastasis of gastric cancer.The combination of the two methods can significantly improve the sensitivity of gastric cancer peritoneal metastasis diagnosis.Therefore,patients with gastric cancer with preoperative CA125 greater than normal should be Abdominal ultrasonography was performed to assess the presence of ascites in the patient.If both are present,laparoscopic exploration should be performed before surgery.If there is metastasis of peritoneal implant,regardless of the degree of metastasis of the patient,if there is no absolute surgical contraindication,it is recommended to remove D1 lymph node dissection for gastric cancer and postoperative chemotherapy. |
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