Detection of residual micro-cancer cells by the assessment of telomerase activities in postoperative pleural effusion after esophagectomy for esophageal cancer

为了确定细胞学检查和端粒酶活性评估是否有助于检测切除部位残留的微小癌细胞，我们对食道癌切除患者术后胸腔积液进行了这些检测。57例食管癌术后胸腔积液细胞学检查阳性(Papanicolaou分级IV、V级)23例(40%)。23例细胞学阳性患者与34例细胞学阴性患者在原发肿瘤侵袭深度、阳性血管侵犯和淋巴结转移发生率方面无差异。前者11例(48%)复发，后者14例(41%)复发。11例细胞学阳性患者中，的肿瘤局部复发率为36.00%，14例细胞学阴性的患者中，肿瘤局部复发率为36%。然而，两组患者…的局部复发率没有显著差异。更多的起伏。23例细胞学阳性患者的4年生存率为60%。同样，在34例细胞学阴性的患者中，这些存活率为60%。我们还检查了其他14例食道癌切除患者术后胸腔积液的细胞学结果与端粒酶活性的相关性。14例患者的细胞学检查均为阴性，胸腔积液中未检测到端粒酶活性。提示部分食管癌患者术后胸腔积液中可见癌细胞散在分布，微小癌细胞残留不是食管癌术后局部复发风险增加的可靠指标，端粒酶活性可能与细胞学检查食管癌术后胸腔积液中残留微小癌细胞有关。较少

To determine whether cytologic examination and telomerase activity assessment are useful to detect residual micro-cancer cells in the resection sites, we performed these tests in the postoperative pleural effusion from patients with esophageal cancer undergoing esophagectomy. Positive cytology (Papanicolaou class IV and V) was detected in the postoperative pleural effusions from 23(40%) of 57 patients with esophageal cancer after esophageal resection. There no difference in depth of primary tumor invasion and frequencies of positive vessel invasion and lymph node metastasis between the 23 patients with positive cytology and 34 patients with negative cytology. Recurrent disease occurred in 11 (48%) of the former patients and 14 (41%)of the latter patients. Local tumor recurrence was found in 64% of the 11 patients with positive cytology and in 36% of the 14 patients with negative cytology. However, there was no significant difference in local recurrence rates between the two patient gro … More ups. The 4-year survival rates of the 23 patients with positive cytology were 60%. Likewise, those survival rates were 60% in the 34 patients with negative cytology. We also examined correlation between cytologic results and telomerase activities assessed by the TRAP method in the postoperative pleural effusions from other 14 patients with esophageal cancer undergoing esophagectomy. All of the 14 patients were revealed to have negative cytology and no detectable telomerase activities in the pleural effusion. These findings suggest that cancer cells can be scattered in the resection sites after esophagectomy in some patients with esophageal cancer, that residual micro-cancer cells are not reliable indicators of increased risk of local tumor recurrence after esophagectomy for esophageal cancer, and that telomerase activities may correlate with cytologic examination to detect residual micro-cancer cells in the postoperative pleural effusions after esophagectomy in patients with the disease. Less