胸腔镜手术与传统开胸肺癌根治术后炎症因子及VEGF水平变化的比较  

Comparison of Postoperative levels of Inflammatory Cytokines and VEGF Between Video-assisted Thoracoscopic and Conventional Open Thoracotomy Surgery for Non-small Cell Lung Cancer

作　　者：张自正[1] 刘汉云[1] 李剑明[1] 张焕荣[1] 钟海辉[1] 梁锦崧[1] 彭广福[1] 

机构地区：[1]梅州市人民医院胸外科,广东梅州514031

出　　处：《肿瘤基础与临床》2013年第4期331-334,共4页journal of basic and clinical oncology

基　　金：广东省科技计划项目(编号:2009B030801062)

摘　　要：目的比较电视胸腔镜手术(VATS)与传统开胸(OT)肺癌根治术对患者术后免疫抑制及预后的影响。方法 50例确诊肺癌或怀疑肺癌的患者,随机分为2组,VATS组24例、OT组26例,采用酶联免疫吸附试验(ELISA)方法检测血清中C-反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)的水平,并比较术前、术后2组患者CRP、IL-6、TNF-α、VEGF水平的变化。结果 2组患者术前血清中的CRP、IL-6、TNF-α、VEGF的水平比较差异无统计学意义(P>0.05),在术后第1、2、3、7天,CRP、IL6、VEGF的水平VATS组低于OT组(P<0.05)。在术后第1、2、3天,TNF-α水平VATS组低于OT组。结论 VATS较OT肺癌根治术对NSCLC患者机体的创伤轻、免疫抑制弱,对于术后肿瘤转移、复发的影响可能较小。Objective To compare the effect of video-assisted thoracic surgery （VATS） and open thoracotomy （OT） on immune function and prognosis of patients with non-small cell lung cancer （NSCLC）. Methods Fifty patients with NSCLC who underwent lobectomy were randomly divided into the VATS group （ n = 24） and the OT group（ n = 26）. The surem levels of C-reactive protein （ CRP）, interleukin-6 （ IL-6）, tumor necrosis factor-α（ TNF- α） and vascular endothelial growth factor （VEGF） were determined by enzyme linked immunosorbent assay （ELISA）. The statistical difference before and after surgery was analyzed. Results There was no significant difference in the preoperative serum levels of CRP, IL-6, TNF-α and VEGF between the two groups. Compared with the OT group, the VATS group showed lower levels of CRP, IL-6 and VEGF on dl,2,3,7 postoperatively （P 〈 0.05 ） ; the VATS group showed lower levels of TNF-α on d1, 2,3 postoperatively （ P 〈 0. 05 ）. Conclusion For the patients with NSCLC, VATS lobectomy has less immunosuppression and less the influence on tumor metastasis and recurrence than OT.

关 键 词：肺癌 电视胸腔镜手术 炎症因子 免疫抑制 血管内皮生长因子 

分 类 号：R734.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]