腹腔镜根治术治疗胃癌的疗效及对肿瘤标志物及氧化应激反应的影响  

Clinical Effect of Laparoscopic Radical Resection on Tumor Markers and Oxidative Stress Response

作　　者：常方圆[1] 邢继丹 刘姗姗 李蓉蓉 张佳[1] 杨瑞净 王姿 CHANG Fangyuan;XING Jidan;LIU Shanshan(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2024年第3期490-493,共4页The Practical Journal of Cancer

摘　　要：目的 探讨腹腔镜根治术治疗胃癌的临床效果及对患者肿瘤标志物及氧化应激水平的影响。方法 选取78例胃癌患者,按随机数字表法分为2组,各39例。对照组行开腹根治术治疗,观察组行腹腔镜根治术治疗。比较两组手术情况、肿瘤标志物、氧化应激水平、炎症水平及并发症发生情况。结果 观察组手术、排气及住院时间分别为(221.52±13.25)min、(1.52±0.39)d、(10.98±2.04)d,较对照组[(257.63±14.13)min、(2.38±0.43)d、(14.39±2.18)d]短,出血量为(209.63±12.43)ml,低于对照组的(296.87±15.38)ml,有统计学差异(P<0.05);观察组术后癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原125(CA125)水平分别为(14.63±2.08)ng/ml、(34.35±3.82)U/ml、(37.25±3.96)U/ml,较对照组[(18.28±2.24)ng/ml、(40.16±4.02)U/ml、(42.58±4.23)U/ml]低,有统计学差异(P<0.05);观察组术后超氧化物岐化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平分别为(67.85±6.14)U/ml、(218.96±23.52)pg/ml,高于对照组的(55.73±6.05)U/ml、(186.74±19.68)pg/ml,丙二醛(MDA)水平为(25.37±3.19)U/L,低于对照组的(30.82±3.57)U/L,有统计学差异(P<0.05);观察组术后C反应蛋白(CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平分别为(20.41±2.86)mg/L、(25.96±3.12)ng/L、(69.85±5.37)ng/L,低于对照组的(26.93±3.12)mg/L、(31.52±3.45)ng/L、(78.52±6.05)ng/L,并发症发生率低于对照组,有统计学差异(P<0.05)。结论 腹腔镜根治术治疗胃癌效果优于开腹根治术,能降低CA199、CEA、CA125水平,减轻机体创伤,抑制氧化应激反应,阻止炎症因子活化,减少并发症发生,值得广泛应用。Objective To study the clinical effect of laparoscopic radical treatment in gastric cancer on tumor markers and oxidative stress levels.Methods 78 gastric cancer patients were selected and divided into 2 groups with 39 patients each.The control group was treated with radical laparotomy and the observation group with laparoscopic radical resection.The surgical conditions,tumor markers,oxidative stress level,inflammation level,and the occurrence of complications were compared between the 2 groups.Results The operation,exhaust,and hospitalization duration in the observation group were(221.52±13.25)min,(1.52±0.39)d,(10.98±2.04)d,which was shorter than(257.63±14.13)min,(2.38±0.43)d,and(14.39±2.18)d of the control group,Bleeding volume was(209.63±12.43)ml,which was lower than(296.87±15.38)ml of the control group,there had statistical difference(P<0.05);The observed postoperative levels of carcinomoembryonic antigen(CEA),sugar antigen 199(CA199),and sugar antigen 125(CA125)were(14.63±2.08)ng/ml,(34.35±3.82)U/ml,(37.25±3.96)U/ml,which was lower than(18.8.28±2.24)ng/ml,(40.16±4.02)U/ml,(42.58±4.23)U/ml of the control group,there had statistical difference(P<0.05);The levels of postoperative superoxide digidase(SOD)and glutathione peroxidase(GSH-Px)were(67.85±6.14)U/ml,(218.96±23.52)pg/ml,which were higher than those in the control group(55.73±6.05)U/ml,(186.74±19.68)pg/ml,The level of malondialdehyde(MDA)was(25.37±3.19)U/L,which were lower than the control group(30.82±3.57)U/L,there had statistical difference(P<0.05);The postoperative levels of C reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were(20.41±2.86)mg/L,(25.96±3.12)ng/L,(69.85±5.37)ng/L,which were lower than(26.93±3.12)mg/L,(31.52±3.45)ng/L,and(78.52±6.05)ng/L of the control group,The complication rate was lower than that of the control group,there had statistical difference(P<0.05).Conclusion Radical laparoscopy is better than open surgery,which can reduce CA199,CEA and CA125 levels,reduce body trauma,inhi

关 键 词：胃癌 腹腔镜手术 开腹手术 肿瘤标志物 炎症因子 肠梗阻 吻合口瘘 

分 类 号：R735.2[医药卫生—肿瘤]