The Significance Of Cytological Examination Of Free Cancer Cell And Expression Of CK20 MRNA In The Peritoneal Cavity Washes Of Laparoscopic Colorectal Resction Patients

Objects:By observing the presence of cancer cell and the expression of CK20mRNA in the peritoneal cavity washes before and after radical resection of colorectal surgery, this study investigates the relationship between the free cancer cells (FCC) in peritoneal cavity washing and tumor stage, lymph node metastasis,tumours differentiation and the method of operation, to provide evidence for the safety of the Laparoscopic colorectal surgery.Methods:Collect the peritoneal cavity washes of 30 cases of laparoscopic surgery group and 30 cases of open surgery group before and after surgery, detect the examination of cytology by HE staining and the expression of CK20mRNA by Nested RT-PCR of the peritoneal cavity washes.Results:Positive rate of FCC by HE staining in preoperative peritoneal cavity washing has no significant relationship with gender, tumor stage, lymph node metastasis, tumor differentiation, tumor location(P>0.05); Positive rate of CK20mRNA in preoperative peritoneal cavity washing is relate with tumor stage and lymph node metastasis(P<0.05), but has no significant relationship with gender, tumor differentiation, tumor location((P>0.05). The expression of CK20mRNA has no difference between preoperative and postoperative peritoneal cavity washing in Laparoscopic, the expression of CK20mRNA also has no difference between preoperative and postoperative peritoneal cavity washing in Open surgery group(P>0.05). Positive rate of HE staining and CK20mRNA has no difference between Laparoscopic surgery and Open surgery group in before surgery, after surgery and changes of preoperative and postoperative(P>0.05). Positive rate of CK20mRNA by Nested RT-PCR is higher than Positive rate of HE staining(P<0.05).Conclusion:1. Compared with open colorectal resection(OCR), Laparoscopic colorectal resection(LCR) may not increase the chance of the shed and spread of cancer cells, however the reliable conclusion require further study.2. For the detection of FCC in peritoneal cavity washing, detection of CK20mRNA by Nested RT-PCR is more senistive than cytological examination by HE staining. Detection of CK20mRNA by Nested RT-PCR in preoperative peritoneal cavity washing may be useful for early discovering of peritoneal micrometastasis.3.The results of the expression of CK20mRNA show that the positive rate of FCC in preoperative peritoneal cavity washing is relevant to tumor stage and lymph node metastasis, suggests that FFC may be one of the prognosis factors of the colorectal cancer patients.