Ｐｈｏｓｐｈａｔｉｄｙｌｉｎｏｓｉｔｏｌ　ｐｈｏｓｐｈｏｌｉｐａｓｅ　Ｃと超音波破砕を併用したＣＥＡ遊出能増強による腹膜播種性転移早期診断法の試み

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  • A Study of Combined Effects of CEA Release using Phosphatidylinositol Phospholipase C and Ultrasound-induced Cell Lysis in Early Peritoneal Dissemination on Diagnosis.

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Purpose: We studied the combined effects of carcinoembryonic antigen (CEA) release from cancer cell (PLC) using phosphatidylinositol phospholipase C (PIPLC) and ultrasound-induced cell lysis (US) in early peritoneal dissemination on diagnosis. Materials and Methods: Materials were 3 CEA-producing human gas-tric cancer cell lines-KATO-III, LoVo and MKN-45-and Subjects 46 gastric cancer patients undergoing gas-trectomy and peritoneal lavage cytology for 1 year 1998. Patients were divided into 4 groups-nontreatment, PLC (0.05U of PIPLC administered into sediment from peritoneal lavage fluid), US (ultrasound-induced cell ly-sis), and USP (combined PLC and US). The reaction was positive if supernatant CEA increased more than 10% compared to the nontreatment group. Results: CEA was higher in cytoplasmic KATO-III and MKN-45 than in apical LoVo. The effect of CEA release was more marked in the USP group versus cytoplasmic. Posi-tive CEA increased gradually by surgical stage grouping and the depth of tumor invasion-23.9% in nontreat-ment, 26.1% in PLC, 26.1% in US, and 28.3% in USP, with USP the most positive. The prognosis of positve groups in USP, PLC, and CY was significantly poorer than in negative groups. In cases showing T2 or T3 with negative peritoneal dissemination, no significant difference was seen in survival curves between positive and negative PLC, but the prognosis of USP (+) was significantly poorer than that of USP (-). Conclusions: The combination of PLC and US, i.e. USP, may be effective in early diagnosis of peritoneal dissemination in gastric cancer patients.

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