不同气腹压腹腔镜技术对结直肠癌外周血微转移的影响  

A study on the influence of CO_2 pneumoperitoneum in colorectal cancer with Laparoscopic on hematogenous micrometastasis

作　　者：秦章禄[1] 郭朝阳[1] 周兴舰[1] 何德[1] 

机构地区：[1]江西省萍乡市人民医院胃肠外科,萍乡337000

出　　处：《江西医药》2016年第5期388-390,共3页Jiangxi Medical Journal

基　　金：江西省科技厅资助项目;编号20122BBG70123

摘　　要：目的探讨不同气腹压腹腔镜技术对结直肠癌外周血微转移的影响。方法将入组的80例结直肠癌患者随机分成A、B、C、D组,每组20例,A组腹腔镜术中气腹压维持在14mm Hg;B组腹腔镜术中气腹压维持在12mm Hg;C组腹腔镜术中气腹压维持在10mm Hg;D组为对照组（传统开腹手术组）,采用RT-PCR方法检测不同气腹压组腹腔镜结直肠癌术患者外周静脉血中CEA m RNA及CK20 m RNA的表达情况,并与开腹组比较。结果 A、B、C、D四组比较术前CEA m RNA表达无统计学差异（χ2=0.559,P=0.906）;四组比较术中CEA m RNA表达无统计学差异（χ2=0.579,P=0.901）;四组比较术后CEA m RNA表达无统计学差异（χ2=1.522,P=0.677）;四组术中、术后CEA m RNA表达阳性率与术前比较无统计学差异比较（χ2=1.146,P=0.979）;A、B、C、D四组术前比较外周静脉血CK20m RNA表达无统计学差异（χ2=0.955,P=0.812）;四组术中比较外周静脉血CK20m RNA表达无统计学差异（χ2=1.023,P=0.796）;术后比较外周静脉血CK20m RNA表达无统计学差异（χ2=2.083,P=0.555）;四组术中、术后外周静脉血CK20m RNA表达阳性率与术前比较亦无统计学差异比较（χ2=0.681,P=0.995）。结论与开腹手术比较,不同气腹压（10-14mm Hg）腹腔镜结直肠癌根治术不增加患者外周静脉血CEAm RNA及CK20m RNA表达。Objective To evaluate the effects of different CO2 pneumoperitoneum pressure on the influence of colorectal cancer micrometastasis in peripheral blood. Methods 80 patients were randomly divided into groups A,B,C and D with 20 cases in each group. Laparoscopic intraoperative CO2 pneumoperitoneum pressure of group A、B、C were maintained at 14、12、10mm Hg;and group D was the control group（traditional open surgery group）. The RT-PCR was applied for the assay of the expression of CEA m RNA and CK20 m RNA in peripheral blood of colorectal cancer patients. Results The expression of CEA m RNA and CK20 m RNA between four groups had no significant differences in the preoperative、intraoperative and postoperative（χ2=0.559,P=0.906;χ2=0.579,P=0.901;χ2=1.522,P=0.677;χ2=0.955,P=0.812;χ2=1.023,P=0.796;χ2=2.083,P=0.555）. The positive rate of CK20 m RNA and CEA m RNA expression had no significant difference between four groups either preoperatively or postoperatively（χ2=1.146,P=0.979;χ2=0.681,P=0.995）. Conclusion Compared with traditional open operation,CO2 pneumoperitoneum pressures（10-14 mm Hg） do not increase CEAm RNA and CK20 m RNA expression in peripheral venous blood in colorectal cancer patients with laparoscopic.

关 键 词：气腹压 腹腔镜 结直肠癌 微转移 

分 类 号：R735.37[医药卫生—肿瘤]