胃癌脱落细胞检查的临床意义

摘要

ObjectiveTo identify the risk factors of positive peritoneal cytology and its prognosis value in patients with gastric cancer. MethodsA total of 142 patients with gastric cancer who had been treated by potentially curative resection were analyzed retrospectively.Cytology was performed for all the patients .Results25(17.6%)patients of 142 preoperative had positive peritoneal cytology. Both univariate and multivariate analysis showed that tumor size,depth of invasion,regional lymph node metastasis correlated with peritoneal cytology, but no significant differences in gender,age,histological grade,vascular invasion,HER2 expression,etc. Survival analysis showed that patients with positive peritoneal cytology had poor prognosis.ConclusionCytology has some significance in terms of prognosis in patients with gastric cancer,it can provide a reference for the individual treatment of patients.%目的：分析胃癌脱落细胞的影响因素及与胃癌患者预后的关系。方法回顾分析D2胃癌根治术患者142例，术中均行腹膜腔脱落细胞学检查。结果142例患者中25例（17.6%）脱落细胞检查术前阳性，术后阴性，单因素、Logistic回归分析多因素分析显示肿瘤大小、浸润深度、区域淋巴结转移差异有统计学意义（P<0.05），但与性别、年龄、组织分化程度、脉管癌栓、HER2表达、术前CEA、CA199血清浓度等差异无统计学意义（P>0.05），生存分析提示患者预后不良，是预后的独立危险因素。结论脱落细胞阳性提示患者预后不良，为个体化治疗提供进一步指导。