腹腔镜手术对子宫颈癌细胞生物行为的影响

Effect of Biological Behavior of Cervical Carcinoma Cells by Laparoscopic Surgery

目的:探讨腹腔镜手术对子宫颈癌细胞增殖和转移能力的影响。方法:子宫颈癌患者20例,在腹腔镜下行广泛子宫全切加盆腔淋巴结清扫术,采用流式细胞术测定术前和术后子宫颈癌细胞凋亡率,以及B cl2、T ra iL、NM 23和M TA 1基因表达水平的变化,并与开腹手术子宫颈癌细胞,以及腹腔镜下子宫全切术正常子宫颈细胞手术前后相对比。结果:子宫颈癌细胞术前凋亡率为(4.36±0.28)%,腹腔镜手术后为(26.65±0.75)%,差异有显著性(P<0.01);开腹手术后为(5.19±0.39)%,与术前相比,差异无显著性(P>0.05)。正常子宫颈细胞腹腔镜手术前后的凋亡率分别为(18.37±0.57)%和(17.47±0.68)%,差异无显著性(P>0.05)。子宫颈癌细胞M TA 1和B cl2基因表达术前为187.65±6.35和55.26±0.47,腹腔镜手术后为117.35±4.66和29.45±0.57,差异有显著性(P<0.01);开腹术后为190.31±5.56和58.77±0.98,差异无显著性(P>0.05)。NM 23和T ra iL基因术前表达率为50.87±0.75和62.16±0.27,腹腔镜术后为67.56±0.76和81.32±0.38,差异有显著性(P<0.01);开腹术后为47.87±0.39和59.79±0.75,差异无显著性(P>0.05)。正常子宫颈细胞M TA 1、B cl2、NM 23和T ra iL基因表达水平术前分别为23.45±0.57、39.33±0.39、19.82±0.21和33.79±0.56,腹腔镜手术后分别为26.42±0.38、40.11±0.42、18.79±0.47和32.56±0.43,差异均无显著性(P>0.05)。结论:腹腔镜手术用于治疗子宫颈癌并不增加其细胞的增殖和转移能力,是一种安全的手术方法。

Objective：To explore the effect of laparoscopic surgery on the growth and metastasis potentiality of cervical carcinoma cells. Methods ： 20 patients with cervical carcinoma underwent laparoscopic extensive total hysterectomy and bilateral adnexectomy and pelvic lymphadenectomy . The cell apoptosis percentage, expression level of Bcl2, TraiL, NM23 and MTA1 gene of cervical carcinoma cells before and after laparoscopic surgery were estimated by low cytometry （FCM）, compared with that of cervical carcinoma cells before and after laparotomic surgery and nomal cervical cells before and after laparoscopic surgery. Result：The cervical carcinoma cell apoptosls percentage,before surgery, was （4.36± 0.28）% ,after laparoscopic surgery was 26.65 ± 0.75 %,there was a different significantly compared with before surgery（P〈0.01）after laparotomic surgery was （5.19±0.39）% ,there was no different significantly compared with before surgery （P〉0.05） ;The normal cervical cell apoptosis percentage before and after laparoscopic surgery was （18.37± 0.57）% and （17.47 ± 0.68）% differentially, there was no different significantly （P〉0.05）. The expression level of MTA1 and Bcl2 gene of cervical carcinoma cells before surgery was 187.65 ± 6.35 and 55.26± 0.47 ,after laparoscopic surgery was 117.35±4.66 and 29.45±0.57 ,there was a different significantly compared with before surgery（P〈0.01）after laparotomic surgery was 190. 31±5.56 and 58.77±0.98, there was no different significantly compared with before surgery（P〉0.05）. The expression level of NM23 and TraiL gene of cervical carcinoma cell before surgery was 50.87±0.75 and 62.16±0.27,after laparoscopic surgery was 67.56±0.76 and 81.32±0.38,there was a different significantly compared with before surgery （P〈0.01）after laparotomic surgery was 47.87 ± 0. 39 and 59. 79± 0. 75, there was no different significantly compared with before surgery（P〉0.05）. The expression level of MTA1 ,Bcl2 ,NM23 and TraiL gene of normal cervical cell before laparoscopic surgery was 23.45±0. 57,39.33±0. 39, 19. 82±0. 21 and 33.79±0.56 differentially,after laparoscopic surgery was 26.42±0. 38,40. 11±0.42,18. 79±0.47 and 32.56±0.43 differentially, There was no different significantly compared with before laparoscopic surgery（P〉0.05）. Conclusion： The treatment of cervical carcinoma via operational laparoscopy doesn＇t elevate the growing and metastasis potentiality of cervical carcinoma cells, is a safe kind of method.