腹腔镜与开腹胃癌手术腹腔冲洗液中IL-1β浓度的变化及其对腹膜间皮细胞与胃癌细胞黏附的影响  

Contents of IL-1β in peritoneal lavage fluid in laparoscopy-assisted and open gastrectomy for gastric cancer and its influence on the adhesion of peritoneal mesothelial cells to gastric cancer cells

作　　者：于歌[1] 唐波[1] 余佩武[1] 钱锋[1] 孙刚[1] 牛嫣阳[1] 

机构地区：[1]第三军医大学西南医院全军普通外科中心,重庆400038

出　　处：《解放军医学杂志》2010年第1期28-31,共4页Medical Journal of Chinese People's Liberation Army

基　　金：全军"十一五"计划课题(06MB240);国家"十一五"攻关项目分题(2006BAI02A06)

摘　　要：目的比较腹腔镜与开腹胃癌手术腹腔冲洗液中白介素1β(IL-1β)浓度的变化,并于体外观察其对腹膜间皮细胞与胃腺癌细胞AGS、SGC-7901黏附的影响,初步探讨腹腔镜胃癌手术对腹膜种植转移的影响。方法将39例胃癌手术患者分为开腹组(n=19)及腹腔镜组(n=20),均行远端胃癌根治术。于术前及术后24、48h分三次采集腹腔冲洗液,采用酶联免疫吸附法(ELISA)检测腹腔冲洗液中IL-1β的浓度。同时以体外原代培养腹膜间皮细胞为实验对象,观察不同浓度IL-1β对腹膜间皮细胞与胃腺癌细胞黏附的影响。结果两组患者术后24、48h腹腔冲洗液中IL-1β水平较术前均升高,且开腹组高于腹腔镜组,差异有统计学意义(P<0.05)。在0～10ng/ml随IL-1β处理浓度的增加,人腹膜间皮细胞与胃癌细胞的黏附率逐渐升高,与未处理组比较差异有统计学意义(P<0.05)。结论IL-1β可特异性地增强腹膜间皮细胞的黏附能力,并促进其与胃癌细胞黏附。与传统开腹手术比较,腹腔镜胃癌手术对腹腔内免疫功能影响小,其微创优势可能在减少创伤性炎症因子介导的肿瘤腹膜转移中发挥作用。Objective To assess the content of interleukin-1β（IL-1β）in peritoneal lavage fluid in radical laparoscopy-assisted and open gastrectomy for gastric cancer and its effect on the adhesion of peritoneal mesothelial cells to gastric cancer cell lines AGS and SGC-7901 in vitro.Methods From Oct.2008 to March 2009,20 patients with gastric cancer underwent radical gastrectomy by laparoscopy-assisted gastrectomy and 19 cases by conventional gastrectomy through laparotomy.The concentrations of IL-1β were measured by immunoassay（ELISA）in peritoneum lavage fluid collected at the beginning of the surgery,and 24h and 48h after surgery.Moreover,a mesothelial cells of primary culture were used to assess their adhering capacity with gastric cancer cells was assessed in the presense of different concentrations of IL-1β in vitro.Results IL-1β levels of peritoneal fluid rose 24h and 48h after operation in both groups,and the levels were significantly higher in open gastrectomy group than in laparoscopy-assisted gastrectomy group（P〈0.05）.With an increase in content of IL-1β,the percentage of AGS and SGC-7901 cells adherent to mesothelial cells was significantly increased compared with that with 0ng/ml IL-1β（P〈0.05）.The effect of IL-1β in enhancing adhesion between mesothelial cells and cancer cells was dose dependent.Conclusions IL-1β can specifically enhance the adhering capacity of peritoneal mesothelial cells with gastric cancer cells.Laparoscopic surgery for the radical treatment of gastric cancer not only it is responses,minimally invasive but also maintains immune response of the peritoneum by producing IL-1β,by which the adherence between peritoneal mesothelial cells with cancer cells is increased,thas lessens peritoneal metastasis of gastric cancer as a result of operative manipulation during gastrectomy.

关 键 词：腹腔镜 胃肿瘤 白细胞介素1Β 细胞黏附 肿瘤转移 

分 类 号：R735.2[医药卫生—肿瘤] R73-37[医药卫生—临床医学]