模式化单孔胸腔镜肺癌根治术对患者肺功能丢失及肿瘤微转移的影响  

Effect of Standardized Thoracoscopic Lobectomy for Lung Cancer on Loss of Lung Function and Tumor Micrometastasis of Patients

作　　者：陈颖 刘长增 李伟[3] Chen Ying;Liu Changzeng;Li Wei(Thoracic Surgery Department,Nanyang City Cancer Hospital,Nanyang,Henan,473000,China)

机构地区：[1]南阳市肿瘤医院胸外科,河南南阳473000 [2]南阳医专第二附属医院胸外科,河南南阳473000 [3]南阳市中心医院胸外科,河南南阳473000

出　　处：《黑龙江医学》2024年第14期1670-1673,共4页Heilongjiang Medical Journal

摘　　要：目的:探究模式化单孔胸腔镜肺癌根治术(VATS)对患者肺功能丢失及肿瘤微转移的影响。方法:选取2021年1月—2022年5月样本医院收治的68例行VATS患者作为研究对象,按照治疗方法不同将其分为研究组(n=34,采用模式化单孔VATS)和对照组(n=34,采用常规三孔VATS),比较两组患者手术相关指标、肺功能指标[第1秒呼吸容积(FEV1)、一氧化碳弥散量(DLCO)、用力肺活量(FVC)]、外周血肿瘤微转移指标[金属基质蛋白酶9(MMP-9)、肺特异性X蛋白(LUNX)、KLF4基因m RNA的相对表达量]、氧化应激指标[血清活性氧(ROS)、缺血修饰白蛋白(IMA)、晚期氧化蛋白产物(AOPP)]、并发症及复发情况。结果:研究组手术用时、术后引流量、术中出血量、住院时间均低于对照组,差异有统计学意义(χ^(2)=4.621、2.314、3.043、5.057,P<0.05);术后,两组患者FEV1、FVC、DLCO均降低,且研究组高于对照组,差异有统计学意义(P<0.05);术后,两组患者外周血MMP-9、LUNX m RNA表达均下降,KLF4 m RNA表达升高,且研究组MMP-9、LUNX m RNA表达低于对照组,KLF4 m RNA表达高于对照组,差异有统计学意义(P<0.05);术后,两组患者血清ROS、IMA、AOPP均升高,且研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率均低于对照组,差异均有统计学意义(χ^(2)=4.660,P<0.05)。结论:模式化单孔VATS能明显改善患者肺功能丢失,降低转移肿瘤细胞活跃度和复发率,促进患者康复和改善预后。Objective:To explore the effect of standardized thoracoscopic lobectomy for lung cancer on loss of lung function and tumor micrometastasis in patients.Methods:68 patients underwent thoracoscopic lobectomy for lung cancer in the hospital from January 2021 to May 2022 were enrolled and classified into two groups by random number table methods,with 34 cases in each group.Control group received multiple-port thoracoscopic lobectomy for lung cancer,while study group received standardized thoracoscopic lobectomy for lung cancer.Then the surgical indicators,lung function parameters(FEV1,FVC and DLCO),tumor micrometastasis parameters in peripheral blood(MMP-9,LUNX and KLF4),oxidative stress index(ROS,IMA,AOPP),and complications and recurrence rate were compared between two groups.Results:Compared with control group,study group had shorter operation time,less intraoperative blood loss,shorter length of stay and lower postoperative drainage volume,with statistically significant difference(χ^(2)=4.621,2.314,3.043,5.057;P<0.05).There was a decrease in the proportions of FEV1,FVC and DLCO in both groups after treatment,and the three lung function parameters were higher in study group than in control group(P<0.05).After surgery,the mRNA expressions of MMP-9 and LUNX in peripheral blood were decreased,while mRNA expression of KLF4 was increased in both groups.Study group had higher mRNA expression of MMP-9 and LUNX,and lower mRNA expression of KLF4 than those of control group,with statistically significant difference(P<0.05).Serum levels of ROS,IMA and AOPP were increased in both groups after surgery,and the three indexes of study group were lower than those of control group(P<0.05).The incidence rate of complications were lower than those in control group,with statistically significant difference(χ^(2)=4.660,P<0.05).Conclusion:Standardized single-pore VATS can significantly improve lung function loss,reduce the activity and recurrence rate of metastatic tumor cells,and promote the recovery and prognosis of patients.

关 键 词：胸腔镜肺癌根治术 单孔 肺功能 肿瘤微转移 临床疗效 

分 类 号：R563[医药卫生—呼吸系统]