加速康复外科对结直肠癌患者术后胰岛素信号传导通路中TRB3表达

Effect of FTS on TRB3 Expression of Insulin Signaling Pathway in Patients with Colorectal Cancer

目的观察加速康复外科(fast-track surgery,FTS)治疗理念对结直肠癌患者术后胰岛素信号传导通路中TRB3表达的影响.方法选择合适的结直肠癌患者,随机分为FTS治疗组(F组)和传统手术方式治疗组(C组),关腹时采取患者腹直肌,利用RT-PCR和western blot测定腹直肌中TRB3的表达水平;并抽取患者静脉血测定患者术后空腹血糖和胰岛素抵抗指数,统计学分析后进行比较.结果 F组术后空腹血糖水平为(8.73±1.12)mmol/L,C组术后空腹血糖水平为(11.15±1.43)mmol/L,F组明显低于C组(P<0.05),F组患者术后胰岛素抵抗指数(6.92±0.42),C组术后胰岛素抵抗指数(9.73±0.27),F组术后胰岛素抵抗明显低于C组(P<0.05).结论FTS理念治疗结直肠癌患者降低了TRB3表达水平,在胰岛素信号传导通路中,有利于AKT/PKB的磷酸化,从而促进GLUT4对葡萄糖的转运,这可能是FTS理念治疗结直肠癌患者改善了胰岛素抵抗的重要机制之一.

Objective To research the impact of fast track surgery （FTS） treatment philosophy on TRB3 expression in insulin signaling pathway of patients with colorectal cancer. Methods Patients with colorectal cancer were randomly divided into FTS group （group F） and traditional surgery group （group C） . The musculus rectus abdominis was obtained at abdomen closure, and the level of TRB3 expression in musculus rectus abdominis was detected by RT-PCR and western blot. The fasting blood glucose and insulin resistance index were measured, analyzed and compared statistically. Results The levels of TRB3 expression and fasting glucose of group FTS were lower than those of group C （P 〈 0.05） . Conclusion FTS treatment could reduce the level of TRB3 expression of patients with colorectal cancer. Promoting the AKT/PKB phosphorylation and glucose transport by GLUT4 and improving the sensitivity of insulin may be the important mechanisms of FTS treatment for patients with colorectal cancer.