CAJ | 학술논문

目的：探讨腹腔镜胃癌根治术患者外周血及腹腔冲洗液中hTERT mRNA的表达及其临床意义。方法临床上将胃癌根治术分为腹腔镜组和开腹组两组，各30例，应用RT-PCR方法检测两组患者术前、术后外周静脉血及腹腔冲洗液人端粒酶亚单位hTERT mRNA的表达，探讨腹腔镜胃癌根治术患者外周血胃癌微转移的情况及对腹腔脱落癌细胞的影响。结果Ⅲ期胃癌患者外周静脉血中的hTERT mRNA阳性率明显高于Ⅰ期、Ⅱ期（P＜0.05）。腹腔镜胃癌根治术患者外周静脉血中的hTERT mRNA术前阳性率为30.00%，术后阳性率为33.33%，两者之间无统计学差异（P＞0.05），手术前后和开腹组无统计学差异（P＞0.05）；Ⅲ期胃癌患者腹腔冲洗液中的hTERT mRNA阳性率明显高于Ⅰ期、Ⅱ期（P＜0.05）。腹腔镜胃癌根治术患者腹腔冲洗液hTERT mRNA术前阳性率为20.00%，术后阳性率为26.67%，两者之间无统计学差异（P＞0.05），手术前后和开腹组无统计学差异（P＞0.05）。结论 hTERT mRNA表达水平可能与肿瘤临床分期有关，传统开腹手术及腹腔镜胃癌根治术均不会增加患者外周静脉血及腹腔冲洗液中hTERT mRNA表达水平，提示腹腔镜胃癌根治术不会增加外周血及腹腔种植转移危险性。
목적：탐토복강경위암근치술환자외주혈급복강충세액중hTERT mRNA적표체급기림상의의。방법림상상장위암근치술분위복강경조화개복조량조，각30례，응용RT-PCR방법검측량조환자술전、술후외주정맥혈급복강충세액인단립매아단위hTERT mRNA적표체，탐토복강경위암근치술환자외주혈위암미전이적정황급대복강탈락암세포적영향。결과Ⅲ기위암환자외주정맥혈중적hTERT mRNA양성솔명현고우Ⅰ기、Ⅱ기（P＜0.05）。복강경위암근치술환자외주정맥혈중적hTERT mRNA술전양성솔위30.00%，술후양성솔위33.33%，량자지간무통계학차이（P＞0.05），수술전후화개복조무통계학차이（P＞0.05）；Ⅲ기위암환자복강충세액중적hTERT mRNA양성솔명현고우Ⅰ기、Ⅱ기（P＜0.05）。복강경위암근치술환자복강충세액hTERT mRNA술전양성솔위20.00%，술후양성솔위26.67%，량자지간무통계학차이（P＞0.05），수술전후화개복조무통계학차이（P＞0.05）。결론 hTERT mRNA표체수평가능여종류림상분기유관，전통개복수술급복강경위암근치술균불회증가환자외주정맥혈급복강충세액중hTERT mRNA표체수평，제시복강경위암근치술불회증가외주혈급복강충식전이위험성。
Objective To investigate the hTERT mRNA expression in peripheral blood and in abdominal rinse solution and its' clinical significance in gastric carcinoma patients who had undergone laparoscopic radical gastrectomy. Methods Classify 60 patients into two groups: laparoscopic group and laparotomy group, 30 in each. Preoperative and postoperative hTERT mRNA in peripheral blood and in abdominal rinse solution were detected through RT-PCR. Effects of laparoscopic radical gastrectomy on peripheral blood micrometastasis or abdominal implantation metastasis were investigated. Results Outcome suggested that there was a significant difference of hTERT mRNA positive rate in Ⅰ, Ⅱ and Ⅲ stage patients (P<0.05). The positive rates of hTERT mRNA in peripheral blood were 30.00% before surgery and 33.33% after surgery. Two groups contrast little with each other (P>0.05). But positive rates of hTERT mRNA in abdominal rinse solution in Ⅰ, Ⅱ andⅢ stage patients contrast with each other significantly (P<0.05). The hTERT mRNA positive rates of abdominal rinse solution in laparoscopic group were 20.00% before surgery and 26.67% after surgery, showing little difference (P>0.05). There was also little difference between laparoscopic group and laparotomy group, both before and after surgery. Conclusion The hTERT mRNA level in peripheral blood and in rinse solution of gastric carcinoma patients has close relationship with clinical stages. Neither laparotomy nor laparoscopic radical gastrectomy will increase hTERT mRNA expression in both abdominal rinse solution and peripheral blood, showing application of laparoscopic radical gastrectomy will not increase the risk of peripheral hematogenous micrometastasis and abdominal metastasis.