内镜下切除与根治性切除治疗早期胃癌的短期创伤程度及远期生存复发情况评估  

Assessment of short-term trauma degree as well as long-term survival and recurrence between endoscopic resection and radical resection treatment of early gastric cancer

作　　者：潘琦[1] 张征[1] 

机构地区：[1]江苏省宜兴市人民医院消化内科,江苏宜兴214200

出　　处：《海南医学院学报》2016年第20期2427-2430,共4页Journal of Hainan Medical University

基　　金：江苏省自然科学基金资助项目(BK2001170)~~

摘　　要：目的:比较内镜下切除与根治性切除治疗早期胃癌的短期创伤程度及远期生存复发情况。方法:对在我院确诊为早期胃癌的187例患者进行回顾性分析,根据手术方式不同分为内镜组和开腹组。随访两组5年生存率和复发率,术后3d时测定血清中创伤相关分子、肿瘤标志分子以及外周血红细胞免疫功能相关指标,术后1年时测定血清中肿瘤标志分子。结果:在5年随访时间内,两组均无死亡病例、生存率达到100%,内镜组3年复发率和5年复发率均与开腹组无显著性差异(P>0.05);术后3d时,内镜组血清中CA199、CA724、OPN、CD44v6、DKK-1、CRP、PA、SAA的含量显著低于开腹组(P<0.05),GAS、MTL的含量以及外周血红细胞的C3bR花环数目、ICR花环数目、CD58、CD59、CR3的荧光强度显著高于开腹组(P<0.05);术后1年时,两组血清CA199、CA724、OPN、CD44v6、DKK-1含量无显著性差异(P>0.05)。结论:内镜下切除治疗早期胃癌的远期疗效与开腹根治性切除术相当且短期的创伤程度弱于开腹手术,术后胃肠功能和红细胞免疫功能受抑制的程度较轻。Objective：To compare the short-term trauma degree as well as long-term survival and recurrence between endoscopic resection and radical resection treatment of early gastric cancer.Methods：A total of 187 patients diagnosed as early gastric cancer in our hospital were retrospectively analyzed and divided into endoscopic group and laparotomy group according to different operation methods.5-year survival rate and recurrence rate of two groups of patients were followed up,trauma-related molecules and tumor markers in serum as well as red blood cell immune function-related indexes in peripheral blood were determined 3dafter operation,and serum tumor markers were determined 1year after operation.Results：Within the 5years of follow-up,there were no death cases in both groups and the survival rate reached 100%,and the 3-year recurrence rate and 5-year recurrence rate of endoscopic group were not significantly different from those of laparotomy group;3dafter operation,serumCA199,CA724,OPN,CD44v6,DKK-1,CRP,PA and SAA levels of endoscopic group were significantly lower than those of laparotomy group while GAS and MTL levels in serum as well as C3 bR rosette number,ICR rosette number,CD58,CD59 and CR3fluorescence intensity in peripheral blood red blood cells were significantly higher than those of laparotomy group;1year after operation,serum CA199,CA724,OPN,CD44v6 and DKK-1levels were not significantly different between two groups of patients.Conclusion：Endoscopic resection treatment of early gastric cancer is with equivalent long-term curative effect to open radical resection and weaker short-term trauma degree than laparotomy,and causes less suppression on postoperative gastrointestinal function and red blood cell immune function.

关 键 词：早期胃癌 内镜下切除术 复发 肿瘤标志物 红细胞免疫 

分 类 号：R735.2[医药卫生—肿瘤]