3D腔镜甲状腺全切术治疗分化型甲状腺癌的效果及对外周血循环肿瘤细胞、肿瘤标志物的影响  

Clinical efficacy of 3D total endoscopic thyroidectomy in the treatment of differentiated thyroid carcinoma and its effect on peripheral blood circulating tumor cells and tumor markers

作　　者：杜学铅 张森焱 冯跃庆[1] 姜东宝 DU Xue-qian;ZHANG Sen-yan;FENG Yue-qing;JIANG Dong-bao(Department of Head,Neck,and Breast Surgery,Xinxiang Central Hospital,Xinxiang 453000,Henan,CHINA)

机构地区：[1]新乡市中心医院头颈乳腺外科,河南新乡453000

出　　处：《海南医学》2023年第18期2627-2631,共5页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20201544)。

摘　　要：目的探究3D腔镜甲状腺全切术(TET)在分化型甲状腺癌(DTC)患者治疗中的应用价值。方法选取2020年9月至2022年9月于新乡市中心医院头颈乳腺外科治疗的60例DTC患者为研究对象,采用随机数表法分为观察组和对照组,每组30例。观察组行3D TET治疗,对照组行常规2D腔镜TET治疗。比较两组患者的手术情况及术后恢复指标、并发症、手术前后循环肿瘤细胞(CTC)水平和肿瘤标志物[甲状腺球蛋白(TG)、降钙素(CTN)、半乳糖血凝素-3(GAL-3)、癌胚抗原(CEA)]水平。结果观察组患者的手术时间、术中及术后出血量均较对照组短(少),淋巴结清扫数量较对照组多,差异均有统计学意义(P<0.05);术后3 d,两组患者的CTC水平较术前升高,且观察组为(27.12±5.84)×10个/mL,明显低于对照组的(32.17±6.49)×10个/mL,差异有统计学意义(P<0.05);术前及术后1个月、3个月,两组患者的血清TG、CTN、GAL-3、CEA较术前持续下降,术后1个月,观察组患者的血清TG、CTN、GAL-3、CEA水平分别为(92.86±11.29)μg/L、(11.35±2.46)ng/L、(4.61±1.08)ng/mL、(19.87±3.05)μg/L,明显低于对照组的(99.32±12.78)μg/L、(12.61±2.37)ng/L、(5.33±1.53)ng/mL、(21.46±2.96)μg/L,差异均有统计学意义(P<0.05);观察组患者术后并发症总发生率为16.67%,略低于对照组的33.33%,但差异无统计学意义(P>0.05)。结论3D TET是DTC安全可靠的治疗方式,可优化手术操作,缩短手术时间,减少术中出血,提高淋巴结清扫范围,减缓CTC分泌。Objective To investigate the application value of 3D total endoscopic thyroidectomy(TET)in the treatment of differentiated thyroid carcinoma(DTC).Methods Sixty DTC patients treated in Department of Head,Neck,and Breast Surgery,Xinxiang Central Hospital from September 2020 to September 2022 were selected and divided into the observation group and the control group using the random number method,with 30 cases in each group.Patients in the observation group were treated with 3D TET,and those in the control group were treated with conventional 2D TET.The operation condition and postoperative recovery indexes,complications,circulating tumour cell(CTC)levels,and tumor markers[thyroglobulin(TG),calcitonin(CTN),galactose haemagglutinin-3(GAL-3),carcinoembryonic antigen(CEA)]levels before and after the operation were compared between the two groups.Results The operation time,intraoperative and postoperative bleeding of patients in the observation group were significantly shorter(less)than those of the control group,and the number of lymph node dissection was significantly more than that of the control group,with statistically significant differences(P<0.05).At 3 d after the operation,the CTC levels of patients in the two groups were elevated compared with those before the operation;the level in the observation group was(27.12±5.84)×10/mL,which was significantly lower than(32.17±6.49)×10/mL of the control group;the differences were statistically significant(P<0.05).At 1 month and 3 months after operation,the serum TG,CTN,GAL-3,and CEA of patients in the two groups continued to decrease compared to those before operation;at 1 month after operation,the levels of serum TG,CTN,GAL-3,and CEA in the observation group were(92.86±11.29)μg/L,(11.35±2.46)ng/L,(4.61±1.08)ng/mL,and(19.87±3.05)μg/L,which were significantly lower than(99.32±12.78)μg/L,(12.61±2.37)ng/L,(5.33±1.53)ng/mL,and(21.46±2.96)μg/L in the control group;and the differences were statistically significant(P<0.05).The total incidence rate of postoperat

关 键 词：分化型甲状腺癌 腔镜甲状腺全切术 3D 外周血循环肿瘤细胞 肿瘤标志物 淋巴结清扫数量 

分 类 号：R736.1[医药卫生—肿瘤]