腹腔镜CME与开腹CME对患者血清学指标及外周血免疫分子含量的影响  

Effect of laparoscopic CME and open CME on serum indexes and peripheral blood immune molecule contents

作　　者：黄建国[1] 孙钦立[1] 周忠晋[1] 田相安 丁元升[1] 

机构地区：[1]临沂市沂水中心医院普外一科,山东临沂276400

出　　处：《海南医学院学报》2015年第7期984-987,共4页Journal of Hainan Medical University

基　　金：临沂市科技技术局(201413038)~~

摘　　要：目的:研究腹腔镜全结肠系膜切除术(CME)与开腹CME对血清炎症应激指标、肿瘤标志物以及外周血T细胞含量的影响。方法:选取在本院接受全结肠系膜切除术的90例右半结肠癌患者纳入研究,接受CME手术并随机分为接受腹腔镜手术的观察组和开腹手术的对照组。采集血清并检测炎症应激指标、肿瘤标志物,采集外周血检测T细胞亚群含量。结果:(1)炎症应激反应:观察组的血清降钙素原(PCT)、单核细胞趋化因子蛋白(MCP-1)、高迁移率族蛋白1(HMGB1)、BG、Glucagons水平低于对照组,Ins水平高于对照组,差异有统计学意义(P<0.05);(2)肿瘤标志物:观察组血清中血管内皮生长因子(VEGF)、可溶性细胞黏附分子-1(sICAM-1)、Pleiotrophin(PTN)、结肠癌特异性抗原-2(CCSA-2)、Imp-1、中期因子(MK)含量低于对照组,差异有统计学意义(P<0.05);(3)免疫分子:观察组外周血中Th1、CD4+CD25+Treg以及CD8+CD28-Treg细胞的百分比高于对照组,Th2、Th17细胞的百分比低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜CME有助于缓解炎症应激反应、减少肿瘤标志物释放入血、调节Th1/Th2、Th17/Treg平衡,是治疗右半结肠癌更为理想的手术方法。Objective： To study the effect of laparoscopic CME and open CME on serum inflammatory stress response indexes, tumor markers and peripheral blood T cell content. Methods： 90 right colon cancer patients received complete mesocolic excision in our hospital were enrolled and scheduled for CME surgery. They were randomly divided into observation group and control group. The observation group received laparoscopic surgery and control group received open surgery. Then serum inflammatory stress response indexes, tumor markers were assayed, peripheral blood were collected and T cell content was assayed. Results： （1） Inflammatory stress response： serum PCT, MCP-1, H MGB-1, BG, Glucagon contents of observation group patients were lower than those of control group; Ins contents were higher than that of control group; （2）tumor markers：serum VEGF, sICAM-1, Ptn, CCSA-2, Imp-1, MK contents of observation group were lower than those of control group; （3）immune molecules ： Th1 cells, CD4 ＋ CD25 ＋ Treg and CD8 ＋ CD28- Treg percentage of observation group patients were higher than those of control group; Th2 and Th17 percentage were lower than those of control group. Conclusion： Laparoscopic CME is helpful to alleviate inflammatory stress reaction, reduce tumor marker releasing into blood, regulate the balance of Th1/Th2, ThlT/Treg; it＇s an ideal method in treating right colon cancer.

关 键 词：结肠癌 全结肠系膜切除术 炎症应激反应 肿瘤标志物 免疫分子 

分 类 号：R735.35[医药卫生—肿瘤]