腹腔镜CO_2气腹对胃癌组织HIF-lα、TAMs及CD34表达的影响

Effect of CO_2 pneumoperitoneum on the expression of HIFlα, TAMs and CD34 in gastric cancer tissues

目的 :探讨腹腔镜手术CO_2气腹对胃癌组织缺氧诱导因子-1α(HIF-lα)、肿瘤相关巨噬细胞(TAMs)及CD34表达的影响。方法:76例胃癌患者随机分组行腹腔镜手术和开腹手术。切取的胃癌组织标本应用免疫组化方法检测HIF-lα、TAMs及CD34表达,并计算微血管密度(MVD)值。结果:腹腔镜组胃癌组织中MVD值略表达高于开腹组,但差异无统计学意义(P=0.561);腹腔镜组胃癌组织中HIF-1α和CD163的阳性表达率均高于开腹手术组,且差异有统计学意义(P=0.001;P=0.002)。结论:与开腹手术相比,CO_2气腹可加重术中胃癌组织缺氧状态,促进TAMs在缺氧区域浸润及肿瘤新生血管形成。

Objective： To investigate the effect of CO2 pneumoperitoneum in laparoscopic operation of gastric cancer patients on HIF- l alpha, TAMs and CD34 expression. Methods： 76 cases of gastric carcinoma were randomly divided into laparoscopic surgery and open surgery groups. After operation specimens of gastric cancer were collected, HIF- l alpha, TAMs and CD34 expression were detected by immunohistochemical method, and the value of MVD was calculted. Results： Value of MVD in gastric cancer tissue in the laparoscopic group was higher than that in the open group, and the difference is not statistically significant（P=0.561）; the positive expression rate of HIF- 1a andCD163 in the laparoscopic group is higher than that of the open surgery group, the difference has statistical significance. Conclusion： Compared with open surgery, CO2 pneumoperitoneum can partly aggravate the gastric cancer tissue hypoxia and promote TAMs infiltration in the anoxic zone,and promote the formation of tumor angiogenesis.