腹腔镜与开腹肝癌切除术对血清和肝癌组织中恶性生物学指标的影响  

Influence of laparoscopic and laparotomy hepatectomy on malignant biological indicator in serum and liver tissue

作　　者：李传斌[1] 胡力[1] 

机构地区：[1]湖北省松滋市人民医院普外二科,湖北松滋434200

出　　处：《海南医学院学报》2015年第6期825-828,共4页Journal of Hainan Medical University

基　　金：湖北省科技计划项目(2011CJ3076)~~

摘　　要：目的:分析腹腔镜与开腹肝癌切除术对血清和肝癌组织中恶性生物学指标的影响。方法:选择于2012年10月至2014年10月间在本院接受手术治疗的原发性肝癌患者138例作为研究对象,按照随机数表法将所有入组患者分为两组,观察组(69例)接受腹腔镜肝癌切除术,对照组(69例)接受开腹肝癌切除术,比较术中两组患者的血清及肝癌组织侵袭相关指标、肝癌组织增殖相关指标等表达差异。结果:(1)观察组患者的术中血清细胞间黏附分子(ICAM-1)、内皮细胞特异性分子(ESM-1)、基质金属蛋白酶(MMP)-13、尿激酶型纤溶酶原激活物(uPA)等指标水平明显低于对照组(P<0.05);(2)观察组患者的术中缺氧诱导因子1α(HIF-1α)、磷酸酯酶基因(PTEN)、原癌蛋白18(Op18)等指标的蛋白表达水平明显低于对照组,γ-连环素(γ-cat)蛋白表达水平高于对照组(P<0.05);(3)观察组患者的术中微小染色体维持蛋白(MCM)7、MCM2、Fas相关磷酸酯酶-1(FAP-1)、Ki67、PCNA等指标的蛋白表达水平明显低于对照组(P<0.05)。结论:接受腹腔镜肿瘤切除术治疗的肝癌患者血清及肿瘤组织中的恶性生物学指标水平较低,可能与接受腹腔镜手术治疗的患者本身病情较轻以及腹腔镜手术过程中牵拉挤压等创伤较小有关。Objective： To explore influence of laparoscopic and laparotomy hepatectomy on malignant biological indicator in serum and liver tissue. Methods： A total of 138 cases with liver cancer between October 2012 to October 2014 underwent sur- gical treatment were selected as research obiect, and according to stochastic indicator method were divided into observation group （69 cases） with laparoscopic resection and control group （69 cases） with laparotomy hepatectomy. Serum and tissue in- vasion related indicators, liver cancer tissue proliferation related index expression were compared. Results： In observation group, serum ESM ICAM-1, MMP-13, uPA index levels were significantly lower than control group （P〈0. 05）; HIF-1α, PTEN and Op18 index of protein expression levels were significantly lower than control group, γ-cat protein expression level was significantly higher than control group （P〈0.05）. MCMT, MCM2,FAP-1 ,Ki67,PCNA index of protein expression levelswere significantly lower than control group（P〈0.05）. Conclusions： Patients with laparoscopic resection therapy have lower bi- ological indicators levels in the serum and tumor tissue. It may be related to lighter disease degree, pull extrusion etc in the process of laparoseopic surgery and small trauma.

关 键 词：肝癌 腹腔镜 恶性生物学指标 

分 类 号：R735.7[医药卫生—肿瘤]