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Detection methods and clinical significance of free peritoneal tumor cells found during colorectal cancer surgery.

机译:大肠癌手术中发现的游离腹膜肿瘤细胞的检测方法及临床意义。

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摘要

Peritoneal washing is now part of the standard clinical practice in several abdominal and pelvic neoplasias. However, in colorectal cancer surgery, intra-peritoneal free cancer cells (IFCC) presence is not routinely investigated and their prognostic meaning is still unclear. When peritoneal washing results are positive for the presence of IFCC a worse outcome is usually expected in these colorectal cancer operated patients, but it what is not clear is whether it is associated with an increased risk of local recurrence. It is authors' belief that one of the main reasons why IFCC are not researched as integral part of the routine staging system for colon cancer is that there still isn't a diagnostic or detection method with enough sensibility and specificity. However, the potential clinical implications of a routine research for the presence IFCC in colon neoplasias are enormous: not only to obtain a more accurate clinical staging but also to offer different therapy protocols, based on the presence of IFCC. Based on this, adjuvant chemotherapy could be offered to those patients found to be positive for IFCC; also, protocols of proactive intraperitoneal chemotherapy could be applied. Although presence of IFCC appears to have a valid prognostic significance, further studies are needed to standardize detection and examination procedures, to determine if there are and which are the stages more likely to benefit from routine search for IFCC.
机译:现在,腹膜清洗已成为几种腹部和盆腔赘生物的标准临床实践的一部分。然而,在大肠癌手术中,没有常规研究腹膜内游离癌细胞(IFCC)的存在,其预后含义仍不清楚。当腹膜冲洗结果为IFCC阳性时,通常预期这些结直肠癌手术患者的预后较差,但尚不清楚是否与局部复发风险增加有关。作者认为,没有将IFCC作为结肠癌常规分期系统的组成部分进行研究的主要原因之一是,仍然没有一种具有足够敏感性和特异性的诊断或检测方法。但是,常规研究对于结肠癌中存在IFCC的潜在临床意义是巨大的:不仅要获得更准确的临床分期,而且要根据IFCC的存在提供不同的治疗方案。在此基础上,可以为发现IFCC阳性的患者提供辅助化疗。同样,可以采用主动腹膜内化疗方案。尽管IFCC的存在似乎具有有效的预后意义,但仍需要进一步研究以使检测和检查程序标准化,以确定是否存在以及哪些阶段更可能从常规搜索IFCC中受益。

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