Abstract:Objective To evaluate the clinical significance of the intraoperative detection of peritoneal micrometastases of gastric cancer.
Methods In selected 50 cases of gastric cancer in which no obvious peritoneal metastasis was found preoperatively or during laparotomy, Douglas′s pouch peritoneal biopsy was undertaken intraoperatively,then HE and CK20 immunohistochemistry staining of the specimens was performed. The expression of CK20 mRNA in peritoneal irrigation fluid was also determined by RTPCR.
Results HE staining of all cases was negative.The positive rate of CK20 immunohistochemistry staining was 24.0％(12/50),and 36.0％(18/50) with RTPCR method.The positive rate of CK20 mRNA was significantly related with the histological type, the depth of invasion and the number of lymph node metastasis (P<0.05).The 3year survival rate of patients with positive and negative expression of CK20 mRNA was 22.2％ and 62.5％ respectively (P<0.01).
Conclusions The detection of CK20 mRNA expression by RTPCR is a sensitive method for determining peritoneal micrometastases in gastric cancer. It may provide evidence for the correct staging, adjuvant chemotherapy and estimation of prognosis of gastric cancer.