The Value Of MRI And Inoperative Detection Of CEA In Peritoneal Lavage In Diagnosis, Treatment And Prognosis Of Gastric Carcinoma Patients

Objective1,To investigate the value of MRI in the preoperative TNM staging of gastric cancer. 2,By detecting carcinoembryonic antigen(CEA), to investigate its value in the preoperative TNM staging of gastric cancer, analysis the relationship between CEA expression and the clinicopathological factors, in order to find a sensitive clinical method and predict gastric cancer peritoneal micrometastases or residual tumor metastasis.3,To investigate the value of the joint of preoperative MR imaging and peritoneal washing in gastric cancer detection, treatment and prognosis.Methods Clinical and pathological data of 50 paitents with laparoscopic gastric surgery were collected, all the patients were confirmed as gastric cancer by preoperative endoscopy and biopsy and taking preoperative whole abdominal MRI examination.Peritoneal lavage fluid from the 50 patients was collected before gatrectomy to detect CEA by FCM. Peritoneal washing of 10 cases of benign lesions was detected by FCM and PLC as a control.Results 1,The accuracy for T-staging detected with MR were 88%,80%in TI,75% in T2,86.9% in T3,100% in T4. The accuracy for N-staging detected with MR were 70.4%.72.7% in NO.71.4% in N1,66.6% in N2. In 3 cases liver metastasis and 4 cases distant lymph node metastasis,all the liver metastasis were detected, but 2 cases distant lymph node metastasis were missed.2, The accuracy for T-staging detected with CEA were 52%,20.0% in TI,25.0% in T2.39.1% in T3,100% in T4. The accuracy for N-staging detected with CEA were 45.4%,36.3% in N0,47.6% in N1,50.0% in N2. All the 3 cases liver metastasis and 4 cases distant lymph node metastasis were detected.3-, The positive expression of CEA was 52%(26/50),which is higher than PLC(52%,26/50),and the positive rates were relative to depth of tumor invasion,TNM staging and lymph node metastasis.The result of 10 cases benign disease was negative.4^ The accuracy for T-staging detected with CEA was lower than MR,but it was higher in T3,T4, while it was well in the detection in metastasis than MR.Conclusions 1-. MR is superior in staging of gastric cancer,especially in T-staging, however, MR has limitation in the evaluation of N-staging. MR is superior in liver metastases, but is poor in judging of peritoneal metastasis.2,Detection of CEA by FCM has a greater role in diagnosis of advanced gastric cancer,and is an effective method for the detection of peritoneal free cancer cells and prediction of peritoneal metastasis, CEA may be more valuable as a predictive indicator of tumor metastasis and recurrence.3,Combined preoperative MR examination and detection of CEA in peritoneal fluid has a greater help in improving the diagnosis of advanced gastric cancer.