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目的探讨腹腔镜胃癌根治术患者外周血及腹腔冲洗液中hTERT mRNA的表达及其临床意义。方法临床上将胃癌根治术分为腹腔镜组和开腹组两组,各30例,应用RT-PCR方法检测两组患者术前、术后外周静脉血及腹腔冲洗液人端粒酶亚单位hTERT mRNA的表达,探讨腹腔镜胃癌根治术患者外周血胃癌微转移的情况及对腹腔脱落癌细胞的影响。结果Ⅲ期胃癌患者外周静脉血中的hTERT mRNA阳性率明显高于Ⅰ期、Ⅱ期(P<0.05)。腹腔镜胃癌根治术患者外周静脉血中的hTERT mRNA术前阳性率为30.00%,术后阳性率为33.33%,两者之间无统计学差异(P>0.05),手术前后和开腹组无统计学差异(P>0.05);Ⅲ期胃癌患者腹腔冲洗液中的hTERT mRNA阳性率明显高于Ⅰ期、Ⅱ期(P<0.05)。腹腔镜胃癌根治术患者腹腔冲洗液hTERT mRNA术前阳性率为20.00%,术后阳性率为26.67%,两者之间无统计学差异(P>0.05),手术前后和开腹组无统计学差异(P>0.05)。结论 hTERT mRNA表达水平可能与肿瘤临床分期有关,传统开腹手术及腹腔镜胃癌根治术均不会增加患者外周静脉血及腹腔冲洗液中hTERT mRNA表达水平,提示腹腔镜胃癌根治术不会增加外周血及腹腔种植转移危险性。
Objective To investigate the expression of hTERT mRNA in peripheral blood and peritoneal washings of patients undergoing laparoscopic radical gastrectomy and its clinical significance. Methods The radical operation of gastric cancer was divided into two groups (laparoscopic group and laparotomy group), 30 cases in each group. RT-PCR method was used to detect the expression of human telomerase subunit in peripheral venous blood and peritoneal wash fluid before and after operation hTERT mRNA expression in patients with gastric cancer undergoing laparoscopic radical gastrectomy in patients with gastric micrometastasis and its impact on the abdomen cancer cells. Results The positive rate of hTERT mRNA in peripheral blood of patients with stage Ⅲ gastric cancer was significantly higher than that of stage Ⅰ and Ⅱ (P <0.05). The positive rate of hTERT mRNA in peripheral venous blood of patients undergoing laparoscopic radical gastrectomy was 30.00%, the positive rate was 33.33%. There was no significant difference between the two groups (P> 0.05) (P> 0.05). The positive rate of hTERT mRNA in peritoneal washings of patients with stage Ⅲ gastric cancer was significantly higher than that of stage Ⅰ and Ⅱ (P <0.05). The positive rate of hTERT mRNA in peritoneal lavage fluid of patients undergoing laparoscopic radical gastrectomy was 20.00% and the postoperative positive rate was 26.67%. There was no significant difference between the two groups (P> 0.05) Difference (P> 0.05). Conclusions The expression of hTERT mRNA may be related to the clinical stage of the tumor. Conventional laparotomy and laparoscopic radical gastrectomy do not increase hTERT mRNA expression in peripheral venous blood and peritoneal washings, suggesting that laparoscopic radical gastrectomy does not increase peripheral Blood and peritoneal metastasis risk.