腹腔镜手术和开腹手术对结肠癌患者血清恶性分子及机体免疫功能的影响

Effect of laparoscopic surgery and open surgery on serum malignant molecules and immune function of patients with colon cancer

目的：研究腹腔镜手术和开腹手术对结肠癌患者血清恶性分子及机体免疫功能的影响。方法：选择2013年5月~2015年9月期间在四川省绵阳市中心医院接受腹腔镜手术和开腹手术的结肠癌患者进行研究,分别纳入腹腔镜组和对照组,手术前和手术后1h,采集血清并测定肿瘤标志物CEA、CA199、CA153、CA125、CA724的含量;手术后当天,采集外周血并测定Th1、Th2、Th17、Treg以及CD86、CD80、CD40、MHC-II比例。结果：术后1h时,腹腔镜组患者血清中肿瘤标志物CEA、CA199、CA153、CA125、CA724的含量以及阳性率均显著低于对照组;手术后当天,腹腔镜组患者外周血单个核细胞中Th1细胞比例以及CD86、CD80、CD40、MHC-II比例高于对照组,Th2、Th17、Treg细胞比例低于对照组。结论：结肠癌患者腹腔镜手术的术中牵拉较小、肿瘤标志物释放入血较少、免疫应答抑制较轻。

Objective：To study the effect of laparoscopic surgery and open surgery on serum malignant molecules and immune function of patients with colon cancer.Methods：Colon cancer patients who received laparoscopic surgery and open sur-gery in our hospital from May 2013 to September 201 5 were selected for study and enrolled in laparoscopic group and control group respectively,and serum was collected before operation and 1 hour after operation to determine serum tumor markers CEA,CA1 99,CA1 53,CA125 and CA724 levels;the very day after operation,peripheral blood was collected to determine Th1,Th2,Th1 7 and Treg as well as CD86,CD80,CD40 and MHC-II percentage.Results：One hour after operation,the lev-els and positive rate of serum tumor markers CEA,CA1 99,CA1 53,CA125 and CA724 of laparoscopic group were significant-ly lower than those of control group;the very day after operation,Th1 cell percentage as well as CD86,CD80,CD40 and MHC-II percentage in peripheral blood mononuclear cells of laparoscopic group were higher than those of control group,and Th2,Th1 7 and Treg cell percentage were lower than those of control group.Conclusions：The traction to colon cancer patients is smaller during laparoscopic surgery,the tumor markers released into the blood are fewer,and the suppression of immune re-sponse is milder.