Monitoring tools for efficacy of intraperitoneal chemotherapy to treat peritoneal dissemination of gastric cancer

腹腔化疗治疗胃癌腹膜播散疗效的监测工具

• 批准号: 20K17579
• 负责人: 稲垣 公太
• 金额: $ 2.66万
• 依托单位: Nagoya University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Early-Career Scientists
• 财政年份: 2020
• 资助国家: 日本
• 起止时间: 2020-04-01 至 2021-03-31
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-20K17579/
• 关键词: 胃癌; 腹膜播種; 腹腔洗浄液; SYT13; 微小遊離癌細胞

胃癌腹膜播種は難治性の病態である。腹腔内遊離癌細胞の検出法として洗浄細胞診が用いられているが、一定の頻度で偽陰性例が存在することが問題となっている。細胞診を凌駕する腹腔内遊離癌細胞検出法が開発できれば、腹膜播種高リスク症例を対象とした治療開発研究の適格基準、腹膜播種治療の効果判定法に活用できる。まず、先行研究で胃癌腹膜播種と胃癌原発組織中発現度が相関することを見出した、9つの候補分子マーカーの性能比較を行った。非担癌患者から得た腹腔洗浄液中をコントールとし、候補マーカーの胃癌患者の手術時洗浄腹腔洗浄液中mRNA発現量を評価した。その結果、腹腔洗浄液中のSYT13とCEAのmRNA発現が有望な微小腹腔内癌細胞検出マーカーであることが判明した。200例の胃癌患者で胃切除時腹腔洗浄液検体中のSYT13 mRNA, CEA mRNAを定量したところ、ともに低値の症例ではほとんど腹膜播種再発が出現せず、一方でSYT13 mRNA高値、 CEA mRNA高値、ともに高値の順に腹膜播種再発率が増大していた。Conversion手術前審査腹腔鏡時の腹腔洗浄液検体および、腹膜播種に対する腹腔内化学療法施行患者のリザーバーから得た腹腔洗浄液検体中のいずれからも開腹手術時の腹腔洗浄液と同等の発現レベルでSYT13 mRNA、 CEA mRNAが検出できた。この技術により、腹腔洗浄液中の分子マーカー発現量によってのちの腹膜播種再発リスクを精緻に評価するバイオマーカー指向型の胃癌診療へとつながることが期待される。

The peritoneum of gastric cancer was seeded with therapeutic infectious disease. In the abdominal cavity, the cancer-free cells were removed from the abdominal cavity. The method was used to wash the cancer cells in the abdominal cavity. In the case of sex with a certain degree of temperature, there was a problem with the disease. The method of intra-abdominal cancer isolation and peritoneal inoculation was used to study the basic level of clinical treatment and the method to determine the effect of peritoneal seeding. First of all, the peritoneal inoculation of gastric cancer was studied. In the primary tissue of gastric cancer, the molecular weight of gastric cancer was higher than that of gastric cancer at the age of 9 years. For non-burden cancer patients, the amount of mRNA in peritoneal lavage fluid should be measured during hand surgery for gastric cancer patients. The results showed that the detection of SYT13 CEA mRNA in peritoneal lavage fluid was hopeful for the diagnosis of microabdominal cancer. SYT13 mRNA was detected in peritoneal lavage fluid of two hundred patients with gastric cancer during gastrectomy, CEA mRNA quantitative assay was used to determine the incidence of peritoneal inoculation, and the rate of peritoneal reimplantation was significantly higher in one patient than in the other. The rate of peritoneal reimplantation was significantly higher in one patient than in the other. The peritoneal lavage fluid was tested immediately before the Conversion operation, and the peritoneal lavage fluid was inoculated into the peritoneum. The peritoneal lavage fluid was used to detect the same concentration of SYT13 mRNA and CEA mRNA in the peritoneal lavage fluid when the abdominal cavity was opened. The molecular weight in the peritoneal lavage fluid, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal wash solution, the molecular weight in the peritoneal wash solution, the molecular weight in the peritoneal lavage fluid, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal lavage solution, the molecular weight in the peritoneal