Objective: To provide clinical evidence of the detection of exfoliated cancer cells ( ECC ) from peritoneal washing fluids of gastric carcinoma patients using flow cytometry ( FCM ) as an assisting approach. Methods: Peritoneal washings and related clinical data from 62 patients with gastric cancer were collected. FCM was used to carry out DNAploidy analysis of ECC, whereas traditional peritoneal lavage cytology ( PLC ) was used to compare the sensitivity of the two methods. The correlation between FCM results and the clinicopathologic features of gastric cancer was analyzed. Results: The positive rate of 62 cancer patients was 67.74% and 33.87% in the FCM and PLC groups, respectively. Significant differences were observed between the two groups (P < 0.001 ). FCM was correlated with tumor type (P = 0.013 ), infiltration depth (P = 0.018 ), area of serous invasion (P = 0.048 ), nodal metastasis ( P = 0.001), vascular tumor embolus (P = 0.048 ), and clinicopathologic staging based on the tumor, nodes, and metastasis classification ( TNM staging ) (P = 0.002 ). FCM was superior to PLC in localizing gastric cancer ( P = 0.003 ), infiltration depth ( P < 0.01 ), invasion area of peritoneum below 10 cm2 ( P = 0.001 ), lymph node metastasis ( P = 0.001 ), vessel tumor embolus negative ( P = 0.001), and TNM staging (P < 0.05 ). Conclusion: FCM can be used as an effective method to detect ECC during surgery and to assist in the diagnosis of gastric cancer.%目的:应用流式细胞技术(flow cytometry,FCM)对腹腔冲洗液进行DNA倍体分析,作为胃癌腹腔脱落癌细胞(exfoliated cancer cells,ECC)检测的辅助手段为临床提供依据.方法:收集62例胃癌患者术中腹腔冲洗液,应用FCM进行脱落细胞DNA倍体分析,同时行腹腔冲洗液细胞学(peritoneal lavage cytology,PLC)检查,比较二者的检测敏感度,并分析FCM与胃癌不同临床病理特征的相关性.结果:62例胃癌腹腔冲洗液流式细胞术DNA倍体分析检测阳性率为67.74%,而PLC阳性率仅为33.87%,两组差异有统计学意义(P<0.001).肿瘤类型、浸润深度、受侵面积、淋巴结转移、脉管瘤栓、TNM分期与腹腔冲洗液异倍体肿瘤细胞相关(P均>0.05).在局限性胃癌、肿瘤浸润深度、浆膜受侵面积<10cm2、淋巴结转移、无脉管瘤栓、TNM分期方面腹腔冲洗液FCM检测阳性率优于PLC(P均<0.05).结论:流式细胞术可作为胃癌患者术中检测ECC的有效辅助诊断手段.
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