腹腔镜手术对结直肠癌患者血清肿瘤标志物及近期复发率的影响  

Effect of laparoscopic surgery on serum tumor marker and recent recurrence rate in patients with colorectal cancer

作　　者：李桥涛 张巧艳 袁应选 LI Qiaotao;ZHANG Qiaoyan;YUAN Yingxuan(First Department of General Surgery,Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,Shaanxi,China;Department of Nephrology,Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,Shaanxi,China;Department of Laboratory Medicine,Xi’an Electric Power Central Hospital,Xi’an 710032,Shaanxi,China)

机构地区：[1]榆林市中医医院普外一科,陕西榆林719000 [2]榆林市中医医院肾病科,陕西榆林719000 [3]西安电力中心医院检验科,西安7100320

出　　处：《癌症进展》2022年第24期2567-2570,共4页Oncology Progress

摘　　要：目的探讨腹腔镜手术对结直肠癌患者血清肿瘤标志物及近期复发率的影响。方法将85例结直肠癌患者按照手术方式的不同分为开腹组(n=42)和腹腔镜组(n=43)。开腹组采用传统开腹手术治疗,腹腔镜组采用腹腔镜根治术治疗。比较两组患者的围手术期指标、胃肠功能指标、肿瘤标志物水平、并发症发生率以及术后1年复发率、死亡率。结果腹腔镜组患者手术时间、下床活动时间、肠蠕动恢复时间、住院时间均明显短于开腹组,术中出血量明显少于开腹组,差异均有统计学意义(P﹤0.01)。手术后,两组患者胃动素及胃泌素水平均降低,但腹腔镜组患者胃动素及胃泌素水平均高于开腹组,差异均有统计学意义(P﹤0.05)。手术后,两组患者癌胚抗原、糖类抗原19-9、糖类抗原125水平均降低,且腹腔镜组患者癌胚抗原、糖类抗原19-9、糖类抗原125水平均低于开腹组,差异均有统计学意义(P﹤0.05)。腹腔镜组患者并发症总发生率低于开腹组,差异有统计学意义(P﹤0.05)。术后1年,腹腔镜组患者复发率和死亡率均低于开腹组,差异均有统计学意义(P﹤0.05)。结论结直肠癌患者应用腹腔镜手术可有效降低血清肿瘤标志物水平,改善围手术期指标和胃肠功能,提高1年生存率,降低复发率。Objective To investigate the effect of laparoscopic surgery on serum tumor markers and recent recurrence rate in patients with colorectal cancer.Method A total of 85 patients with colorectal cancer were divided into open group(n=42,received traditional open operation)and laparoscopic group(n=43,received laparoscopic radical surgery)according to different surgical methods.The perioperative indicators,gastrointestinal function indexs,tumor markers level,incidence of complications,tumor recurrence rate and mortality 1 year after surgery were compared between the two groups.Result The operation time,ambulation time,bowel motility recovery time,hospital stay and intraoperative blood loss in the laparoscopic group were lower than those in the open group(P<0.01).After surgery,serum motilin and gastrin in both groups decreased,with higher levels in the laparoscopic group than those in the open group(P<0.05).After surgery,serum carcinoembryonic antigen,carbohydrate antigen 19-9,and carbohydrate antigen 125 levels decreased,with lower levels in the laparoscopic group than those in the open group(P<0.05).The incidence of complications in the laparoscopic group was lower than that in the open group(P<0.05).The 1-year recurrence rate and mortality in the laparoscopic group were lower than those in the open group(P<0.05).Conclusion Laparoscopic surgery in patients with colorectal cancer can effectively reduce serum tumor markers,improve perioperative indicators and gastrointestinal function,increase 1-year survival rate,and reduce recurrence rate.

关 键 词：结直肠癌 腹腔镜根治术 肿瘤标志物 近期复发率 

分 类 号：R735.3[医药卫生—肿瘤]