A NEWLY DEVELOPED METHOD EMPLOYING CEA RELEASING BY PHOSPHATIDYLINOSITOL PHOSPHOLOPASE C AND ULTRASOUND-INDUCED CELL LYSIS FOR EARLY DIAGNOSIS OF PERITONEAL DISSEMINATION

【目的】在此之前，我们设计了一种新的方法（PLC），利用磷脂酰肌醇磷脂酶C （PIPLC）从癌细胞中释放癌胚抗原（CEA）来早期诊断腹膜播散。本研究通过引入超声诱导细胞裂解法（USP法）对PLC方法进行改进，提高了其对腹膜播散早期检测的灵敏度，并对其有效性进行了实验和临床评价。【材料】本研究以3种CEA产生人胃癌细胞系（KATO-III、LoVo、MKN-45）和196例胃癌患者为研究对象。[方法]在PLC病例中，在腹膜灌洗液的沉淀物中加入0.05U的PIPLC。在USP病例中，在PLC中加入超声诱导细胞裂解程序，并与常规灌洗细胞学（CY）的阳性率进行比较。[结果]USP对细胞塑型KATO -III和MKN-45的治疗效果优于根尖型LoVo。腹腔播散组USP阳性率为94.1%，T1组为0%。USP、PLC、CY的检出率分别为15.3%、9.5%、5.4%，其中USP检出率最高。USP、PLC、CY阳性组预后均明显差于阴性组。PLC阳性组与PLC阴性组预后无显著差异，但USP阳性组预后明显差于USP阴性组。结论：USP是早期诊断腹膜播散更有效的方法。

[Purpose] Formerly, we devised novel method (PLC) employing the release of carcinoembryonic antigen (CEA) from cancer cells by phosphatidylinositol phospholipase C (PIPLC) for early diagnosis of peritoneal dissemination. This time, the PLC method was improved to obtain higher sensitivity for early detection of peritoneal dissemination by introducing ultrasound-induced cell lysis (USP method), and its usefulness was evaluated experimentally and clinically.[Materials] Three cell lines of CEA producing human gastric cancer (KATO-III, LoVo, MKN-45) and 196 patients with gastric cancer were the subjects of this study.[Methods] In the case of PLC, 0.05U of PIPLC was added in the sediment obtained from peritoneal lavaged fluid. In the cases of USP, a procedure of ultrasound-induced cell lysis was added to PLC Each positive rate was compared with that of conventional lavage cytology (CY).[Results] The effect of USP was better in KATO -III and MKN-45 with cytoplastic type than in LoVo with apical type. The positive rate of USP in the group with peritoneal dissemination was 94.1%, and was 0% in the group with T1. The positive rates of USP, PLC and CY were 15.3%, 9.5%, 5.4%,respectively with USP showing the highest rate. The prognosis of positive groups of USP, PLC and CY were significantly poorer than those of the negative groups in all cases. The prognosis of PLC positive group and PLC negative group was not significantly different, but that of USP positive group was significantly poorer than that of USP negative group.[Conclusion] From above results, USP is suggested as a more useful method for early diagnosis of peritoneal dissemination.