결장직장암에서 진단기법으로서 복강 세척액 세포진단의 의의: 전향적 연구
A Prospective Study on the Significance of Peritoneal Washing Cytology as a Diagnostic Modality in Colorectal Cancer
소속 상세정보
KMID : 0356720070230060483
Abstract
Purpose: Free intraperitoneal cancer cells exfoliated from a tumor are considered to be responsible for peritoneal dissemination. Therefore, microscopic evaluation of cells washed from the peritoneal cavity during surgery for various intraabdominal malignancies has been used to detect subclinical intraperitoneal metastases from these tumors. The purposes of this study were to detect intraperitoneal free cancer cells at the time of surgery by using peritoneal washing cytology in colorectal cancer and to evaluate their diagnostic significance.
Methods: During the 29-month period from January 2000 through May 2002, 149 randomly selected patients with primary colorectal cancer without evidence of gross peritoneal metastasis underwent peritoneal washing cytologic analysis before surgical manipulation of the tumor. Peritoneal washing cytology was compared with the pre-existing prognostic factors.
Results: Positive peritoneal washing for free cancer cells was found in 19 of 149 patients (12.8%). This positivity was significantly correlated with histologic grade (P=0.002), serosal invasion (P=0.025), lymph node metastasis (P=0.034), Astler-Coller classification (P=0.008), recurrence (P＜0.001), and 5-year survival (P＜0.001). Cancer-specific survival was significantly associated with histologic grade (P=0.025), peritoneal washing cytology (P＜0.001), lymph node metastasis (P＜0.001), recurrence (P＜0.001), and stage (P= 0.010) in the multivariate analysis.
Conclusions: The presence of free cancer cells was predictive of survival and was an independent prognostic factor. This information may be useful in stratifying patients with colorectal cancer for therapeutic trials, such as intraperitoneal chemotherapy. J Korean Soc Coloproctol 2007; 23:483-489
키워드
유리종양세포;결장직장암;복강 세척액 세포진단
Free cancer cells;Colorectal cancer;Peritoneal washing cytology
원문 및 링크아웃 정보
등재저널 정보