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目的通过检测腹腔镜胃癌根治术患者与开腹胃癌根治术患者的外周静脉血液微转移发生的情况,探讨腹腔镜胃癌根治术对胃癌细胞血循环微转移的影响。方法本研究采用FQ-PCR技术,以细胞角蛋白(CK19)mRNA为标志物,以51例胃癌患者为研究对象,分为腹腔镜组(14例)及开腹组(37例),分别行腹腔镜胃癌根治术及开腹胃癌根治术;在手术前后采取静脉血,提取RNA,检测其血液微转移发生情况。结果两组患者手术前后CK19差异均无统计学意义(均>0.05)。术前Ⅲ期CK19mRNA表达阳性率为53.85%,Ⅰ期+Ⅱ期阳性率为20.00%,差异有统计学意义(=0.0197);术后Ⅲ期CK19mRNA表达阳性率为60.71%,Ⅰ期+Ⅱ期阳性率为30.00%,差异有统计学意义(=0.0173)。结论腹腔镜胃癌根治术并不增加静脉血CK19mRNA的阳性率,不增加术后肿瘤血循微转移的危险性。
Objective To investigate the effect of laparoscopic radical gastrectomy on microcirculation of gastric cancer cells in patients with laparoscopic radical gastrectomy and open radical gastrectomy for gastric cancer. Methods In this study, FQ-PCR technique was used. The cytokeratin (CK19) mRNA was used as a marker and 51 patients with gastric cancer were studied. The patients were divided into laparoscopic group (14 cases) and laparotomy group (37 cases). Laparoscopic radical gastrectomy for gastric cancer and radical gastrectomy for gastric cancer; venous blood was taken before and after surgery to extract RNA and detect the occurrence of micrometastasis in the blood. Results There was no significant difference in CK19 before and after surgery between the two groups (all >0.05). The positive rate of CK19 mRNA expression in stage III was 53.85%, and the positive rate in stage I+II was 20.00%. The difference was statistically significant (=0.0197). The positive rate of CK19 mRNA expression in stage III was 60.71%, phase I+II. The positive rate was 30.00% and the difference was statistically significant (= 0.0173). Conclusion Laparoscopic radical gastrectomy does not increase the positive rate of CK19 mRNA in venous blood, and does not increase the risk of tumor metastasis after surgery.