腹腔镜下完整结肠系膜切除术与传统开腹手术对患者术后肿瘤恶性生物学的影响  

Effect of laparoscopic complete mesocolic excision and traditional laparotomy on postoperative biological indexes of patients with malignant tumor

作　　者：云文耀 湛文龙[1] 吴礼武 刘德伟[1] 陈海涛[1] 赖光芒 

机构地区：[1]增城市新塘医院胃肠肛门外科,广东增城511340 [2]广东省普宁市人民医院胃肠外科,广东普宁515300

出　　处：《海南医学院学报》2015年第7期995-997,1001,共4页Journal of Hainan Medical University

基　　金：2013年度揭阳市科研计划项目(20130304)~~

摘　　要：目的:研究腹腔镜下完整结肠系膜切除术与传统开腹手术对患者术后肿瘤恶性生物学的影响。方法:选择在我院进行结肠癌手术的患者进行前瞻性研究,筛选接受腹腔镜手术的40例患者和传统开腹手术的40例患者,分别纳入腹腔镜组和开腹组。采集腹腔冲洗液并检测增殖调节分子含量,采集血清并检测肿瘤标志分子以及免疫分子含量。结果:(1)增殖调节分子:与开腹组患者腹腔冲洗液指标比较,腹腔镜组腹腔冲洗液中P16、DCL-1含量较高,Cyclin D1、CDK4、P-gp、MDR-1的含量较低(P<0.05);(2)肿瘤标志分子:与开腹组患者血清肿瘤标志分子的含量比较,腹腔镜组患者血清中结肠癌特异性抗原-2(CCSA-2)、3′sulfo-Lewis、膜联蛋白(Annexin)-A5、中期因子(MK)、PTN、sIL-2R含量较低(P<0.05);(3)免疫分子:与开腹组患者血清免疫分子的含量比较,腹腔镜组患者血清中HAb18G、CD147、Lgr5、CD34、D2-40、CD40的mRNA含量较高(P<0.05)。结论:与开腹手术比较,腹腔镜手术有助于抑制肿瘤增殖、减少肿瘤标志分子释放、增加免疫分子含量,是创伤更小的手术方式。Objective： To study the effect of laparoscopic complete mesocolic excision and traditional laparotomy on biological indexes of patients with malignant tumor. Methods： Patients received colorectal cancer operation in our hospital were chosen for prospective study. A total of 40 undergoing laparoscopic operation and 40 undergoing traditional laparotomy were screened and enrolled into laparoscopic group and laparotomy group, respectively. Then abdominal washing fluid was collected to detect contents of proliferation-regulating molecules; serum was collected to detect contents of tumor markers and immune molecules. Results： Compared with laparotomy group, P16, DCL-1, serum CCSA-2, 3%ulfo-Lewis, Annexin AS, MK, PTN and slL-2R contents of laparoscopic group were higher; Cyclin D1, CDK4, P--gp, MDR-1 contents, mRNA contents of HAbl8G, CD147, Lgr5, CD34, D2-40 and CD40 were lower. Conclusion： Compared with laparotomy, laparoscopic operation is helpful to inhibit tumor proliferation, reduce release of tumor markers and increase immune molecule contents; it＇s a less in vasive operation mode.

关 键 词：结肠癌 腹腔镜 恶性生物学 增殖 免疫功能 

分 类 号：R735.35[医药卫生—肿瘤]