Abstract
PURPOSE: Our laboratory has previously shown that tumors are more easily established and grow larger after laparotomyvs. laparoscopy. The purpose of this study was to better characterize these differences in tumor growth by assessing tumor cell proliferationvia the proliferating cell nuclear antigen assay, which has been shown to be a reliable marker of cellular proliferation. METHODS: Female C3H/He mice (N=40) were inoculated intradermally in the dorsal skin with 106 cultured mouse mammary carcinoma cells <1 hour before interventions. Anesthesia control mice underwent no procedure. Laparotomy group mice had a midline incision from xiphoid to pubis that was closed after 20 minutes. Insufflation group mice underwent CO2 pneumoperitoneum (4–6 mmHg) for 20 minutes. On postoperative Day 6, tumors were excised from one-third of the mice in each group, and from the remaining mice on postoperative Day 12. Sections were made and stained immunohistochemically for proliferating cell nuclear antigen, and the proliferative index of each tumor was determined by taking the average of proliferating cell nuclear antigen-positive cells in five high-power fields (×450), counted in a blinded fashion with the aid of an optical grid. RESULTS: On postoperative Day 6, the mean proliferative index for the laparotomy group was significantly higher than those for both the insufflation (P<0.04) and the control (P<0.001) groups. Of note, the proliferative index of the insufflation group was significantly higher than that of the control (P<0.01) group. Similarly, on postoperative Day 12, the mean proliferative index for the laparotomy group was significantly higher than for both the insufflation (P<0.05) and the control (P<0.005)groups. The proliferative index in the insufflation group was also significantly higher than that of the control (P<0.04) group. CONCLUSIONS: We have demonstrated that there is a significantly higher rate of tumor cell proliferation with the mouse mammary carcinoma cell tumor line after laparotomy than after pneumoperitoneum or anesthesia alone at two postoperative times. Additionally, insufflation alone increases postoperative tumor cell proliferation but to a lesser extent than laparotomy. The mechanism underlying these findings is unclear.
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References
Allendorf JD, Bessler M, Kayton M,et al. Tumor growth after laparoscopy and laparotomy in a murine model. Arch Surg 1995;130:649–53.
Allendorf JD, Marvin MR, Bessler M,et al. Tumors grow larger after laparotomyvs laparoscopy in immunocompetent mice but not in athymic mice. Surg Forum 1996;47:150–2.
Trokel MJ, Bessler M, Treat MR, Whelan RL, Nowygrod R. Preservation of immune response after laparoscopy. Surg Endosc 1994;8:1385–8.
Allendorf JD, Bessler M, Whelan RL,et al. Better preservation of immune function after laparoscopic-assistedvs. open bowel resection in a murine model. Dis Colon Rectum 1996;39:S67–72.
Mathews MB, Bernstein RM, Franza BR,et al. Identity of the proliferating cell nuclear antigen and cyclin. Nature 1984;309:374–6.
Ergomont AM, Steller EP, Marquet RL,et al. Local regional promotion of tumor growth after abdominal surgery is dominant over immuno therapy with interleukin-2 and lymphokine activated killer cells. Cancer Detect Prev 1988;12:421–9.
Goshima H, Saji S, Furata T,et al. Experimental study on preventive effects of lung metastases using LAK cells induced from various lymphocytes—special references to enhancement of lung metastasis after laparotomy stress. J Jpn Surg Soc 1989;90:1245–50.
Ratajczak HV, Lange RW, Sothern RB,et al. Surgical influence on murine immunity and tumor growth: relationship of body temperature and hormones with splenocytes. Proc Soc Exp Biol Med 1992;199:432–40.
Southall JC, Lee SW, Allendorf JD, Bessler M, Whelan RL. Colon adenocarcinoma and B-16 melanoma grow larger after laparotomyvs. laparoscopy in a murine model [abstract]. Dis Colon Rectum 1997;40:A20.
Jacobi CA, Sabat R, Bartholomaus B,et al. Pneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells. Surgery 1997;121:72–8.
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Lee, S.W., Southall, J.C., Allendorf, J.D. et al. Tumor proliferative index is higher in mice undergoing laparotomyvs. CO2 pneumoperitoneum. Dis Colon Rectum 42, 477–481 (1999). https://doi.org/10.1007/BF02234171
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DOI: https://doi.org/10.1007/BF02234171