Research On Omental Bursa By Digestion Of Trypsin For Gastric Carcinoma

ObjectiveTo explore the diagnosis new method for omental bursa metastasis ofgastric carcinoma, provide guidance for surgical resection and postoperativeindividualized treatment.MethodsSelect58patients with gastric carcinoma in our hospital from january2012to october2013,divide into two groups for A and B by simple randommethod. The group A was35patients, take the omental bursa digestion andwash by0.25%trypsin-EDTA solution.The group B was23patients, take theomental bursa wash by normal saline.Detect the expression ofCEA,CK7,CK20and HPA in the washing precipitation from58patients withgastric carcinoma by the immunohistochemical method andHematoxylin-Eosin staining.ResultsIn group A,the positive of HE staining was16cases(the positive ratewas45.71%). the positive of immunohistochemical was29cases(thepositive rate was82.86%).In group B, the positive of HE staining was4 cases(the positive rate was17.39%). the positive of immunohistochemicalwas11cases(the positive rate was47.83%). Comparative analysis betweengroups and within groups,The difference was statistically significant.Comparative the relation of immunohistochemical results and theclinical pathological factors in group A,the expression of CEA in washingwas related with the differentiation,depth of invasion,lymph metastasis andthe site of tumor (P＜0.05). The expression of CK7、CK20and HPA inwashing were related with the differentiation,the depth of invasion and thelymph metastasis of tumor(all P＜0.05).The expression of CEA、CK7、CK20and HPA in washing were unrelated with sex and age(P＞0.05).In group A, the results of the correlation analysis in tumor markers.Jointdetection of CEA、CK7、CK20and HPA,the positive rate have been betterthan any single which diagnosis of omental bursa metastasis for gastriccarcinoma.The correlation analysis in tumor markers,CEA was positivelycorrelated with the HPA(r=0.488,p=0.003),the positive correlation was alsonoted between expression of CK7and CEA(r=0.389,P=0.021),the postive ofCEA was uncorrelated with the CK20(r=0.299,p=0.081).there weresignificant correlation between CK7、CK20and HPA(P＜0.05).Conclusions1. Omental bursa digestion and washing by Trypsin-EDTA Solutioncould improve the diagnosis sensitivity of peritoneal metastasis of gastriccancer. 2. Compared to peritoneal lavage cytology,detect combine CEA、CK7、CK20and HPA by immunohistochemical could increased the diagnosissensitivity for omental bursa metastasis of gastric carcinoma.3. In omental bursa washing by trypsin-EDTA for gastric carcinoma,theexpression of CEA、CK20and HPA were very close correlation of theclinicopathological factors,which could guide the clinical surgical resectionrange and individualized treatment.4. There were positive correlation expression between CK7、CK20andHPA of omental bursa in gastric cancer cell metastasis.