论文部分内容阅读
目的:应用RT-PCR评估直肠冲洗液的量(冲洗量)对直肠癌保肛手术中清除肿瘤脱落细胞的影响。方法:对94例进展期直肠癌患者行保肛手术,留取术中冲洗液,按冲洗量分为A、B、C 3组。A组冲洗量1 000 ml,B组冲洗量1 500 ml,C组冲洗量2 000 ml。RT-PCR检测冲洗液中CEA mRNA的表达水平,同时与细胞学检测的结果做对比。结果:A、B、C 3组患者直肠冲洗液肿瘤脱落细胞的CEA mRNA阳性检出率分别为32.3%(10/31例)、19.4%(6/31例)和6.3%(2/32例),差异具有统计学意义(P=0.03)。3组细胞学阳性检出率分别为19.4%(6/31例)、9.7%(3/31例)和0。结论:随着直肠冲洗量增加,肿瘤脱落细胞的检出率逐步降低,直肠冲洗量至少应在2 000 ml以上,或者行反复冲洗。RT-PCR具有高灵敏度,是细胞学检测很好的补充。
OBJECTIVE: To evaluate the effect of rectal fluid (rinse volume) on the removal of tumor cells during anal sphincter preservation by RT-PCR. Methods: 94 patients with advanced colorectal cancer underwent anal sphincter preservation surgery, the retention of irrigation fluid, according to the amount of irrigation were divided into A, B, C 3 group. A group of flushing 1 000 ml, B flushing volume 1 500 ml, C flushing volume 2 000 ml. The expression level of CEA mRNA in rinse solution was detected by RT-PCR and compared with the results of cytology. Results: The positive rates of CEA mRNA in rectal irrigating fluid were 32.3% (10/31), 19.4% (6/31) and 6.3% (2/32) in group A, B and C, respectively ), The difference was statistically significant (P = 0.03). The positive rates of cytology in the three groups were 19.4% (6/31), 9.7% (3/31) and 0, respectively. Conclusion: With the increase of rectal flushing volume, the detection rate of tumor exfoliated cells is gradually decreased. The rectal flushing volume should be at least 2 000 ml, or repeated washing. RT-PCR with high sensitivity, cytology detection is a good complement.