腹腔镜结直肠癌根治术对肿瘤微转移影响的临床研究

A clinical study and analysis of influence of laparoscopic resection of colorectal cancer on micrometastasis of tumor

目的探讨腹腔镜结直肠癌根治术对患者肿瘤微转移的影响。方法以细胞角蛋白20(eytokeratin,CK-20)mRNA为靶基因,运用逆转录一聚合酶链反应方法(RT-PCR),观察58例结直肠癌患者手术前后外周血肿瘤细胞数量的变化。结果腹腔镜手术组术后外周血肿瘤细胞增加数量低于传统开腹手术组(P<0.05)。腹腔镜手术组术后外周血肿瘤细胞数量增加的程度与患者年龄无关(P>0.05),而与手术时间的长短有明显的关系(P<0.05)。结论腹腔镜结直肠癌根治术有增加术后肿瘤血行转移的危险性,但较开腹手术小;手术时间大于4h者术后发生血行转移的危险性明显加大。

[Objective] To investigate the influence of laparoscopic resection of coloreetal cancer on postoperative micro-metastasis of the tumor. [Methods] Using eytokerafin 20 （CK-20） mRNA as the target gene, the RT-PCR method was used to examine the pre-operative and post-operative changes in the number of tumor cells in the peripheral blood of 58 cases with colorectal cancer： [Results] After operation, the number of tumor cells in the peripheral blood was lower in the laparoseopic surgery group than in traditional laparotomy group （P 〈0.05）. The degree of increase in the number of tumor cells in peripheral blood after laparoscopic surgery was not related to patients＇ age （P 〉0.05）, but was significantly related to the duration of operation （P 〈0.05）. [Conclusions] Laparoseopic resection of colorectal cancer may increase the risk of blood metastasis but to a less extend compared with traditional laparotomy, and this risk is even higher in patients with the operation time longer than 4 hours.