腹腔镜肝部分切除术对肝癌患者肿瘤标志物及纤维化、炎性指标的影响研究

Study on the influence of laparoscopic partial hepatectomy on the tumor markers and fibrosis,inflammatory indexes of patients with liver cancer

目的:研究分析腹腔镜肝部分切除术对肝癌患者肿瘤标志物及纤维化、炎性指标的影响。方法:选取2012年1月至2014年3月手术治疗的64例肝癌患者作为研究对象,随机分为对照组(开腹肝部分切除术,n=32)与观察组(腹腔镜肝部分切除术,n=32),分别检测两组患者术前及术后不同时间的血清肿瘤标志物、纤维化及炎性指标,并进行对比分析。结果:术后第3天、第7天及第14天,观察组患者血清透明质酸、Ⅲ型前胶原肽、Ⅳ型胶原、血清降钙素原、超敏C反应蛋白及白介素6低于对照组(P<0.05),两组血清甲胎蛋白、癌胚抗原及糖类抗原199差异无统计学意义(P>0.05),但均低于术前(P<0.05)。结论:腹腔镜肝部分切除术可有效降低肝癌患者肿瘤标志物及纤维化指标,且对患者造成的炎性应激相对更小。

Objective：To study and analyze the influence of laparoscopic partial hepatectomy on the tumor markers and fibro- sis, inflammatory indexes of patients with liver cancer. Methods：Sixty-four patients with liver cancer from Jan. 2012 to Mar. 2014 were the study objects, and they were randomly divided into control group （open partial hepatectomy group, n = 32 ） and observation group （laparoscopic partial hepatectomy group, n = 32 ） , then the serum tumor markers, fibrosis and inflammatory indexes of two groups before the operation and on third, seventh and fourteenth day after the operation were respectively detected and compared. Results：The serum hyaluronic acid, procollagen-Ⅲ-peptide, type IV collagen of observation group at third, seventh and fourteenth day after the operation were all lower than those of control group, serum procalcitonin, high-sensitivity C-reactive protein and interleukin-6 were all lower than those of control group （P 〈 0.05 ） ,while the serum alpha-fetal protein, eareino-embryonic antigen and carbohydrate antigen 199 of two groups were not significantly different （ P 〉 0.05 ）, but the levels were all lower than those before the operation （ P 〈 0.05 ）. Conclu- sions ： The laparoscopic partial hepatectomy can effectively decrease the tumor markers and fibrosis indexes of patients with liver cancer, and the inflammatory stress is relatively smaller.