早期宫颈癌腹腔镜手术对肿瘤种植和转移能力相关分子表达的影响

Influence of carbon dioxide pneumoperitoneum-laparoscopic surgery on expression of molecules related to tumor seeding and metastasis in early-stage cervical cancer

目的探讨早期宫颈癌腹腔镜手术对肿瘤细胞自身的生物学行为种植和转移潜能的可能影响。方法选择2005年9月～2006年9月FIGO临床分期Ⅰa2～Ⅱa,行腹腔镜手术的宫颈癌病例20例和同期行开腹手术的病例10例。用荧光定量RT-PCR的方法检测手术开始前和结束后的癌组织E-cadherin、MMP-2、VEGF-C和CD44v6mRNA的表达量。结果分别比较腹腔镜组和开腹组手术前后的E-cadherin、MMP-2、VEGF-C和CD44v64种mRNA的表达量差异无显著性(P>0.05)。在腹腔镜组和开腹组之间分别比较手术前后E-cadherin、MMP-2、VEGF-C和CD44v6四种mRNA含量的变化情况差异均无显著性(P>0.05)。腹腔镜组随访(14.85±3.53)个月(7～19个月),无1例复发;开腹组随访(14.20±4.47)个月(7～19个月),1例阴道残端复发。结论20例早期宫颈癌腹腔镜手术没有促进在肿瘤种植和转移过程中起重要作用的一些分子的表达。

[Objective] To explore the possible influence of laparoscopic surgery on the biological behavior of tumor cells about seeding and metastasis in early-stage cervical cancer. [Methods] Between September 2005 and September 2006, 20 cases of cervical cancer were selected for laparoscopic surgery and 10 cases for laparotomic surgery. The cases were FIGO stage Ⅰa2～Ⅱa. The mRNA levels of E-cadherin, matrix metalloproteinase -2 （MMP- 2）, vascular endothelial growth factor-C （VEGF-C） and CD44v6 were detected by fluorescent-quantitative RT-PCR in tumor tissues both before and after operation. [Results] The values of E-cadherin, MMP-2, VEGF-C, and CD44v6 mRNA were of no significant difference after and before operations in both laparoscopic and laparotomic groups （P〉0.05）. There was no statistical difference in the changes of E-cadherin, MMP-2, VEGF-C and CD44v6 mRNA between laparoscopic group and laparotomic group after and before operation （P 〉0.05）. The mean follow- up period in the laparoscopic group was （14.85±3.53） months （range 7～19） and （14.20±4.47） months （range 7～19） in the laparotomy group. No recurrence was detected in laparoscopic group and one vault recurrence in laparotomy group. [Conclusions] 20 cases of laparoscopic surgery for cervical cancers doesn＇t increase the expressions of some molecles important for tumor cell seeding and metastases.