胸腔镜下肺癌根治术对非小细胞肺癌患者炎性因子、T淋巴细胞亚群及肿瘤微转移因子水平的影响  

Effect of thoracoscopic radical resection of lung cancer on inflammatory factors,T-lymphocyte subsets and tumor micrometastasis factors of non-small cell lung cancer patients

作　　者：史可峰 钱如林[1] 杨冉[2] 郑晓东[2] SHI Kefeng;QIAN Rulin;YANG Ran;ZHENG Xiaodong(Department of Thoracic Surgery,He’nan Provincial Chest Hospital,Zhengzhou 450000,He’nan,China;Department of Thoracic Surgery,Anyang Cancer Hospital,Anyang 455000,He’nan,China)

机构地区：[1]河南省胸科医院胸外科,郑州450000 [2]安阳市肿瘤医院胸外科,河南安阳455000

出　　处：《癌症进展》2022年第9期931-934,共4页Oncology Progress

摘　　要：目的探讨胸腔镜下肺癌根治术对非小细胞肺癌(NSCLC)患者炎性因子、T淋巴细胞亚群及肿瘤微转移因子水平的影响。方法根据手术方式的不同将128例NSCLC患者分为对照组(n=63,接受传统开胸肺癌根治术)和研究组(n=65,接受胸腔镜下肺癌根治术)。比较两组患者的手术情况、炎性因子[C反应蛋白(CRP)及白细胞介素-6(IL-6)]水平、T淋巴细胞亚群水平、肿瘤微转移因子[基质金属蛋白酶7(MMP7)mRNA、可溶性主要组织相容性复合体Ⅰ类相关分子A(sMICA)、血管内皮生长因子(VEGF)]表达水平及并发症发生情况。结果研究组患者的术中出血量、术后引流量均明显少于对照组,术后引流管留置时间、术后住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。术后,两组患者的CRP、IL-6水平均高于本组术前,研究组患者的CRP、IL-6水平均低于对照组,差异均有统计学意义(P﹤0.05)。术后,两组患者的CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)均低于本组术前,研究组患者的CD3^(+)、CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P﹤0.05)。术后,两组患者的MMP7 mRNA、sMICA、VEGF表达水平均低于本组术前,研究组患者的MMP7 mRNA、sMICA、VEGF表达水平均低于对照组,差异均有统计学意义(P﹤0.05)。研究组患者的术后并发症总发生率低于对照组(P﹤0.05)。结论与传统开胸肺癌根治术相比,胸腔镜下肺癌根治术治疗NSCLC具有手术创伤小、患者恢复快等优势,而且能够降低患者的炎性因子和肿瘤微转移因子水平,改善免疫功能。Objective To explore the effect of thoracoscopic radical resection of lung cancer on inflammatory factors,T-lymphocyte subsets and tumor micrometastasis factors of non-small cell lung cancer(NSCLC)patients.Method A to-tal of 128 NSCLC patients were divided into the control group(n=63,received traditional thoracotomy for lung cancer)and the study group(n=65,received thoracoscopic radical resection of lung cancer)according to different surgical meth-ods.The operation conditions,inflammatory factors[C-reactive protein(CRP)and interleukin-6(IL-6)],T-lymphocyte subsets,tumor micrometastasis factors[matrix metalloproteinase 7(MMP7)mRNA,soluble MHC class I-related chain A(sMICA),vascular endothelial growth factor(VEGF)],and the occurrence of complications were compared between the two groups.Result The intraoperative blood loss,postoperative drainage in the study group were lower than those in the control group,the postoperative drainage catheterization time,and hospital stay in the study group were shorter than those in the control group,the differences were statistically significant(P<0.01).After the operation,the levels of CRP and IL-6 in the two groups were higher than those before the operation,and the levels of CRP and IL-6 in the study group were lower than those in the control group(P<0.05).After the operation,the levels of CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in the two groups were lower than those before the operation,with higher levels in the study group than those in the control group(P<0.05).After the operation,the expression levels of MMP7 mRNA,sMICA,and VEGF in the two groups were lower than those before the operation,with lower levels in the study group than those in the control group(P<0.05).The total incidence of postoperative complications in the study group was lower than that in the control group(P<0.05).Conclusion Compared with traditional thoracotomy for lung cancer,thoracoscopic radical resection of lung cancer has the advantages of less trauma and faster recovery in treatment of NSCLC pati

关 键 词：胸腔镜下肺癌根治术 非小细胞肺癌 炎性因子 T淋巴细胞亚群 肿瘤微转移 

分 类 号：R734.2[医药卫生—肿瘤]