腹腔镜胃癌手术腹腔冲洗液中sICAM-1、sCD44v6表达的影响及其意义

Expressions and significances of sICAM-1 and sCD44v6 in peritoneal lavage fluid after laparoscopically assisted radical gastrectomy

目的 探讨腔镜胃癌手术腹腔冲洗液中可溶性细胞间黏附分子（sICAM-1）、可溶性CD44变异体（sCD44v6）浓度的变化及意义,以此评价腔镜胃癌手术对腹膜种植转移的危险性.方法 92例胃癌患者,按照随机数字表法分为对照组和试验组,对照组采用传统开腹手术,试验组采用腹腔镜手术,采用酶联免疫吸附法检测两组患者腹腔冲洗液中sICAM-1、sCD44v6的浓度水平,并比较两组患者的肿瘤细胞阳性率.结果 手术前对照组与试验组sICAM-1、sCD44v6水平差异无统计学意义（t=0.198,P =0.543;t =0.897,P=0.429）,手术后两者水平较手术前显著升高,但两组间比较差异无统计学意义（t =0.766,P=0.312;t=1.092,P=0.129）.结论 腹腔镜胃癌根治术并不增加腹腔冲洗液中sICAM-1、sCD44v6的表达,没有增加胃癌腹膜种植转移的危险性,值得临床进一步推广研究.

Objective To explore the expressions and significances of sICAM-1 and sCD44v6 in peritoneal lavage fluid after laparoscopically assisted radical gastrectomy,in order to evaluate the risk of laparoscopically assisted radical gastrectomy for the peritoneal plant transfer.Methods Ninety-two patients with gastric cancer were randomly divided into the control group and the experimental group.The control group was treated with open laparotomy and the experimental group was treated with laparoscopic surgery.The concentrations of both sICAM-1 and sCD44v6 were detected by enzyme linked immunosorbent assay.The positive rates of tumor cells in the two groups were compared.Results The expressions of sICAM-1,sCD44v6 in the two groups before operation had no significant difference （t =0.198,P =0.543 ; t =0.897,P =0.429）.After operation,sICAM-1 and sCD44v6 levels increased significantly,but there was no significant difference between the two groups （t =0.766,P =0.312 ; t =1.092,P =0.129）.The positive rates of tumor cells in the two groups before and after operation have no significant differences （χ^2 =0.789,P =0.287 ; χ^2 =0.912,P =0.198）.Conclusion Laparoscopically assisted radical gastrectomy does not increase the expression of sICAM-1 and sCD44v6 in peritoneal lavage fluid and the risk of peritoneal metastasis.It is worthy of clinical poptdarization and application.