解剖性肝切除术对肝癌患者免疫指标及 MIF、MAGE-1 mRNA、AFP mRNA水平的影响  

Effects of anatomic hepatectomy on immune indexes, MIF,MAGE-1 mRNA and AFP mRNA levels in patients with liver cancer

作　　者：施喆 韩艳珍[1] 李桂芳 李献平[2] 胡景景 安西全 SHI Zhe;HAN Yanzhen;LI Guifang;LI Xianping;HU Jingjing;AN Xiquan(Department of General Srugery,Affiliate Hospital of Hebei Engineering University,Hebei 056002,China;Handan Infectious Disease hospital,Handan,Hebei056002,China)

机构地区：[1]河北工程大学附属医院普外科,河北邯郸056002 [2]邯郸市传染病医院,河北邯郸056002

出　　处：《中国实验诊断学》2024年第11期1266-1270,共5页Chinese Journal of Laboratory Diagnosis

基　　金：河北省卫健委课题(20220653)。

摘　　要：目的 探讨解剖性肝切除术和局部肝切除术对肝癌患者免疫指标和巨噬细胞移动抑制因子(MIF)、黑色素瘤抗原-1信使核糖核酸(MAGE-1 mRNA)、甲胎蛋白信使核糖核酸(AFP mRNA)水平的影响。方法 回顾性分析河北工程大学附属医院2020年1月至2022年10月行肝癌切除术100例患者,观察组50例行解剖性肝切除术,对照组50例行局部肝切除术。对两组患者的手术情况、术前和术后1周的免疫指标,术前和术后1个月的血清MIF、MAGE-1 mRNA、AFP mRNA阳性表达水平及术后1个月内的并发症进行比较。结果 观察组手术时间长于对照组,观察组术中出血量、术中输血量均少于对照组,观察组切缘有效率高于对照组;与术前比较,术后1周两组外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、CD19^(+)均降低,但观察组高于对照组;两组外周血CD8^(+)均升高,但观察组低于对照组;两组血清MIF、MAGE-1 mRNA、AFP mRNA阳性表达水平均降低,且观察组低于对照组;术后1个月内观察组并发症总发生率为12.00%,明显低于对照组的28.00%,差异均有统计学意义(P<0.05)。结论 解剖性肝切除术应用于肝癌患者可有效减少术中出血量和输血量,提高切缘有效率,促进免疫功能改善,减轻免疫炎性反应,降低MAGE-1 mRNA、AFP mRNA阳性表达水平,具有较低的并发症发生率。Objective To investigate the application effects of anatomic hepatectomy and partial hepatectomy in patients with liver cancer and the effects on immune indexes, the level of macrophage migration inhibitory factor(MIF),melanoma antigen-1 messenger RNA(MAGE-1 mRNA) and alpha-fetoprotein messenger RNA(AFP mRNA).Methods A retrospective analysis was conducted on 100 patients who underwent liver cancer resection surgery in our hospital from January 2020 to October 2022.50 patients underwent partial liver resection surgery as observation group and 50 patients underwent anatomical liver resection surgery as control group.Both groups were observed continuously for 1 month after operation.The operation conditions and immune indexes before operation and 1 week after operation, serum positive expression levels of MIF,MAGE-1 mRNA and AFP mRNA before operation and 1 month after operation, and complications 1 month after operation were compared between the two groups.Results The operation time of the observation group was longer than that of the control group.The amount of intraoperative blood loss and intraoperative blood transfusion in the observation group was less than that in the control group.Compared with before operation, CD3^(+),CD4^(+),CD4^(+)/CD8^(+) and CD19^(+) in peripheral blood decreased in both groups 1 week after operation, but the observation group was higher than the control group.CD8^(+) in peripheral blood increased in both groups, but the observation group was lower than the control group.MIF,MAGE-1 mRNA and AFP mRNA decreased in both groups, and the observation group was lower than the control group.The total incidence of complications in the observation group was 12.00%,which was significantly lower than that in the control group(28.00%),with statistical significance(P<0.05).Conclusion The application of anatomic hepatectomy in patients with liver cancer could effectively reduce intraoperative blood loss and blood transfusion volume, improve the resection margin effective rate, promote the improvement

关 键 词：肝癌 解剖性肝切除术 免疫指标 巨噬细胞移动抑制因子 

分 类 号：R735.7[医药卫生—肿瘤]