臨床外科68巻6号

2013年06月発行

特集 胃癌腹膜転移治療の最前線

胃癌腹腔内微小転移のメカニズムとその検出

著者： 中西速夫¹ 舎人誠¹ 村上弘城³ 伊藤友一² 三澤一成² 伊藤誠二²

所属機関： ¹愛知県がんセンター研究所腫瘍病理学部 ²愛知県がんセンター中央病院消化器外科 ³愛知県蒲郡市立病院外科

ページ範囲：P.636 - P.640

【ポイント】

◆腹膜転移の初発巣（微小転移）は大網や腸間膜に存在する乳斑に好発する．

◆その後の腹腔内への播種性進展は，癌細胞，中皮細胞，炎症細胞から分泌されるTNF-αなどの炎症性サイトカインにより促進される．

◆腹膜微小転移はCEAなどを指標とする遺伝子診断により高感度に検出できる．

参考文献

1）Nakanishi H, Mochizuki Y, Kodera Y, et al：Chemosensitivity of peritoneal micrometastases as evaluated using a green fluorescence protein（GFP）-tagged human gastric cancer cell line. Cancer Sci 94：112-118, 2003

2）Hagiwara A, Takahashi T, Sawai K, et al：Milky spots as the implanted site for malignant cells in peritoneal dissemination in mice. Cancer res 53：687-692, 1993

3）Mochizuki Y, Nakanishi H, Kodera Y：TNF-alpha promotes progression of peritoneal metastasis as demonstrated using a green fluorescence protein（GFP）-tagged human gastric cancer cell line. Clin Exp Metastasis 21：39-47, 2004

4）Nakanishi H, Kodera Y, Tatematsu M, et al：Detection of carcinoembryonic antigen-expressing free tumor cells in peritoneal washes from patients with gastric cercinoma by the polymerase chain reaction. Jpn J Cancer Res 88：687-692, 1997

5）Kodera Y, Nakanishi H, Tatematsu M, et al：Prognostic value and clinical implications of disseminated free cancer cells in the peritoneal cavity detected by reverse transcriptase polymerase chain reaction and cytology. Int J Cancer 79：429-433, 1998

6）Nakanishi H, Kodera Y, Tatematsu M, et al：A rapid quantitative detection of CEA expressing free tumor cells in the peritoneal cavity of the patients with gastric cancer using the LightCycler. Int J Cancer 89：411-417, 2000

7）Kodera Y, Nakanishi H, Yamamura Y, et al：Quantitative detection of disseminated free cancer cells in peritoneal washes with real-time RT-PCR：a sensitive predictor of outcome for gastric carcinomapatients. Ann Surg 235：499-506, 2002

8）Ishii T, Fujiwara Y, Ohnaka S, et al：Rapid genetic diagnosis with the transcription-reverse transcription concerted reaction system for cancer micrometastasis. Ann Surg Oncol 11：778-785, 2004

9）Ohashi N, Nakanishi H, Kodera Y, et al：Intraoperative quantitative detection of CEA mRNA in the peritoneal lavage of gastric cancer patients with transcription reverse-transcription concerted（TRC）method：a comparative study with real-time quantitative RT-PCR. Anticancer Res 27（4c）：2769-2777, 2007

10）Ito S, Nakanishi H, Kodera Y, et al：Prospective validation of quantitative CEA mRNA detection in peritoneal washes in gastric carcinoma patients. Br J Cancer 93：986-992, 2005

11）Mori K, Aoyagi K, Ueda T, et al：Highly specific marker genes for detecting minimal gastric cancer cells in cytology negative peritoneal washings. Biochem Biophys Res Commun 313：931-937, 2004

12）Ikehara Y, Niwa T, Nakanishi H, et al：A carbohydrate recognition-based drug delivery and controlled release system using intraperitoneal macrophages as a cellular vehicle. Cancer Res 66：8740-8748, 2006

13）Ito S, Kodera Y, Nakanishi H, et al：PhaseⅡ clinical trial of postoperative S-1 monotherapy for gastric cancer patients with free intraperitoneal cancer cells detected by real-time RT-PCR. World J Surg 34：2083-2089, 2010