Prognostic significance of peritoneal minimal residual disease in gastric cancer detected by reverse transcription-polymerase chain reaction
Prognostic significance of peritoneal minimal residual disease in gastric cancer detected by reverse transcription-polymerase chain reaction
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DOI：
10.1002/bjs.4455
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发表时间：
2004-04-01
影响因子：
9.6
通讯作者：
Maesawa, C
中科院分区：
文献类型：
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作者：
Oyama, K;Terashima, M;Maesawa, C
背景资料：应用实时定量逆转录-聚合酶链反应（real-time quantitative reverse transcription-polymerase chain reaction，RQ-RT-PCR）技术，建立了一种检测腹腔微小残留病的方法。方法：对195例胃癌患者和20例无症状胆囊结石患者进行腹腔镜胆囊切除术后腹腔镜胆囊切除术后腹腔镜胆囊通过RQ-RT-PCR测量腹膜冲洗液中的CEA mRNA表达（p-CEA mRNA），并将其标准化为甘油醛-3-磷酸脱氢酶mRNA表达。通过检测p-CEA mRNA，确定胃癌p-CEA mRNA的临界值。结果：195例胆囊结石患者中55例（28.2%）p-CFA mRNA阳性。p-CEA mRNA阳性率与临床病理因素相关。在163例接受根治性手术的患者中，p-CFA mRNA阳性患者的总生存率和无病生存率明显低于p-CEA mRNA阴性患者（P < 0.001）。考克斯回归分析显示，只有p-CEA mRNA是显著的独立预后因素（P = 0.034）。多因素Logistic回归分析显示p-CEA mRNA是胃癌腹膜复发的独立危险因素（P = 0.027）。结论：p-CEA mRNA是胃癌腹膜复发的可靠预测因子。
Background: A sensitive method for detecting minimal residual disease in the peritoneal cavity by quantifying carcinoembryonic antigen (CEA) mRNA using real-time quantitative reverse transcription-polymerase chain reaction (RQ-RT-PCR) was developed. The clinical value of the method for predicting peritoneal recurrence in patients with gastric cancer was evaluated.Method: A total of 195 patients with gastric cancer and 20 with asymptomatic cholecystolithiasis were included in the study. CEA mRNA expression in peritoneal washings (p-CEA mRNA) was measured by RQ-RT-PCR and normalized to glyceraldehyde-3-phosphate debydrogenase mRNA expression. The cut-off level of p-CEA mRNA for gastric cancer was determined by examining p-CEA mRNA. levels in patients with asymptomatic cholecystolithiasis.Results: Fifty-five (28.2 per cent) of the 195 patients were p-CFA mRNA positive. The rate of p-CEA mRNA positivity correlated significantly with clinicopathological factors. In 163 patients who underwent curative surgery, overall survival and disease-free survival were significantly poorer in p-CFA mRNA-positive patients than in p-CEA mRNA-negative patients (P < 0.001). Cox regression analysis revealed that only p-CEA mRNA was a significant independent prognostic factor (P = 0.034). Multivariate logistic regression analysis showed that p-CEA mRNA was a significant independent risk factor for peritoneal recurrence (P = 0.027).Conclusion: These results suggest that p-CEA mRNA is a reliable prognostic factor and predictor of peritoneal recurrence in gastric cancer.