腹腔镜直肠癌根治术对直肠癌患者血清MMP-9、TIMP-1和免疫细胞含量的影响

The Effect of Laparoscopic Radical Resection of Rectal Cancer on Levels of Serum MMP-9,TIMP-1 and Immune Cells in Patients with Rectal Cancer

目的探究腹腔镜直肠癌根治术对直肠癌患者血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶抑制剂-1(TIMP-1)及细胞免疫功能的影响。方法以本院2016年3月至2018年3月行腹腔镜直肠癌根治术的50例与传统开腹直肠癌根治术50例患者为研究对象,分别为观察组与对照组。比较两组手术相关指标、治疗前后血清MMP-9、TIMP-1及免疫功能指标。结果观察组术中出血量、术后排气时间、住院时间及并发症发生率均显著小于对照组(P <0. 05);两组手术时间、淋巴结清扫数目比较差异均无统计学意义(P>0. 05);与术前比较,两组术后血清MMP-9、CD4^+、CD4^+/CD8^+均显著下降,TIMP-1、CD8^+均明显上升,差异有统计学意义(P <0.05);观察组术后血清MMP-9、CD8^+均显著低于对照组,TIMP-1、CD4^+、CD4^+/CD8^+均显著高于对照组,差异有统计学意义(P<0.05)。结论腹腔镜直肠癌根治术相比传统开腹直肠癌根治术能明显降低MMP-9水平,提高TIMP-1水平,对机体免疫功能的影响显著减小。

Objective To explore the effect of laparoscopic radical resection of rectal cancer on serum matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1)levels and cellular immune function in patients with rectal cancer.Methods 50 patients who underwent laparoscopic radical resection of rectal cancer and 50 patients received conventional open radical resection of rectal cancer in the hospital from March 2016 to March 2018 were selected as the study group and the control group ,respectively.The operation associated indexes,serum MMP-9 and TIMP-1 and immune function indexes before and after the treatment were compared between the two groups.Results The intraoperative blood loss,postoperative exhaust time, length of hospital stay and the incidence of complications in the observation group were significantly less/shorter/lower than those in the control group (P<0.05).There was no significant difference between the two groups for the operative time or the number of removed lymph nodes(P>0.05).Serum MMP-9,CD4^+ and CD4^+/CD8^+ in the two groups decreased significantly,while TIMP-1 and CD8^+ increased significantly after the operation (P<0.05).The levels of serum MMP-9 and CD8^+ in the observation group were significantly lower than those in the control group,while TIMP-1,CD4^+ and CD4^+/CD8^+ were significantly higher than those in the control group (P<0.05).Conclusion Laparoscopic radical resection of rectal cancer can significantly reduce the level of MMP-9 and improve the level of TIMP-1,and it has less influence on the immune function of patients.