内镜黏膜下剥离术治疗胃肠神经内分泌肿瘤的疗效  

Efficacy of endoscopic submucosal dissection in the treatment of gastrointestinal neuroendocrine tumor

作　　者：连艳珍 张文静[1] 李文悌 LIAN Yanzhen;ZHANG Wenjing;LI Wenti(Department of Clinical Laboratory,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,He’nan,China)

机构地区：[1]郑州大学第一附属医院检验科,郑州450000

出　　处：《癌症进展》2024年第12期1331-1334,共4页Oncology Progress

摘　　要：目的探讨内镜黏膜下剥离术治疗胃肠神经内分泌肿瘤(NET)的疗效。方法将80例胃肠NET患者按手术方法的不同分为切除组(45例)和剥离组(35例),切除组患者行内镜下黏膜切除术,剥离组患者行内镜黏膜下剥离术。比较两组患者围手术期相关指标(手术时间、术中出血量、术后住院时间)、血清肿瘤标志物[糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)]、炎症指标[白细胞介素-6(IL-6)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)]、病灶切除情况及并发症发生情况。结果剥离组患者手术时间明显长于切除组,术后住院时间明显短于切除组,差异均有统计学意义(P﹤0.01)。术后,两组患者CA125、CA19-9、CEA、IL-6水平和NLR、PLR均较术前降低,且剥离组患者CA125、CA19-9、CEA、IL-6水平和NLR、PLR均低于切除组,差异均有统计学意义(P﹤0.05)。剥离组患者治愈性切除率、整块切除率均高于切除组,差异均有统计学意义(P﹤0.05)。两组患者术后并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论胃肠NET患者采用内镜黏膜下剥离术能够缩短术后住院时间,降低血清肿瘤标志物以及炎症指标水平,有效清除病灶,疗效更好。Objective To investigate the efficacy of endoscopic submucosal dissection in the treatment of gastrointes-tinal neuroendocrine tumor(NET).Method A total of 80 patients with gastrointestinal NET were divided into resection group(45 cases)and dissection group(35 cases)according to different surgical methods.Endoscopic mucosal resection was performed in resection group and endoscopic submucosal dissection was performed in dissection group.Periopera-tive indicators(operation time,intraoperative blood loss,postoperative hospital stay),serum tumor markers[carbohydrate antigen125(CA125),carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin-6(IL 6),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)],lesion resection and complications were compared between the two groups.Result The operation time in the dissection group was signifi-cantly longer than that in the resection group,and the postoperative hospital stay was significantly shorter than that in the resection group,the differences were statistically significant(P<0.01).After surgery,the levels of CA125,CA19-9,CEA,IL-6,NLR and PLR in two groups were lower than those before surgery,and the levels of CA125,CA19-9,CEA,IL-6,NLR and PLR in the dissection group were lower than those in the resection group,the differences were statistically sig-nificant(P<0.05).The curative resection rate and total resection rate in the dissection group were higher than those in the resection group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Endoscopic submucosal dissec-tion in gastrointestinal NET patients can shorten the length of hospital stay,reduce the level of serum tumor markers and inflammatory indicators,and effectively remove the lesion,with better efficacy.

关 键 词：胃肠神经内分泌肿瘤 肿瘤标志物 炎症指标 内镜黏膜下剥离术 内镜下黏膜切除术 

分 类 号：R735[医药卫生—肿瘤]