腹腔镜结肠系膜切除术与开腹术对结肠癌术后肿瘤生物学的影响

Effect of laparoscopic complete mesocolic excision and tradional laparotomy on postoperative biological parameters of patients with malignant tumor

目的探讨腹腔镜和开腹完整肠系膜切除术对结肠癌患者术后相关肿瘤生物学行为的影响。方法以2013年7月至2015年1月在我院进行手术医治的80例结肠癌患者为研究对象,依据术式的不同将所研究对象分为腹腔镜组和开放组,各40例,采集患者的腹腔冲洗液和外周静脉血,对冲洗液中增值调节分子、血清肿瘤标志分子以及免疫分子的含量进行比较分析。结果开放组腹腔冲洗液P16和DCL-1含量较腹腔镜组低,而Cyclin D1、CDK4、P-gp、MDR-1含量确比腹腔镜高(P<0.05);开放组患者血清中结肠癌CCSA-2、3′sulfo-Lewis、Annexin-A5、MK、PTN、SIL-2R含量均较腹腔镜组高(P<0.05);血清中HAb18G、CD147,Lgr5,CD40,CD34,D2-40的m RNA含量开放组均明显低于腹腔镜组(P<0.05)。结论腹腔镜手术对肿瘤的增值不仅具有抑制作用,还可减少肿瘤标志分子释放、增加机体免疫分子的含量。

Objective To investigate the effect of laparoscopic and open CME on the biological behavior of the tumor associated with colon cancer. Methods Eighty cases of colon cancer patients treated in our hospital from July 2013 to January and two cases of colon cancer patients were divided into the laparoscopic group and the open surgery group, 40 cases in each.The peritoneal washing liquid and peripheral venous blood were collected. Results The concentrations of P16 and DCL-1 in the open surgery group were lower than those in the laparoscopic group, while D1 CDK4, P-gp, Cyclin and MDR-1 were higher than those of the laparoscopic group（P〈0.05）; The CCSA-2, 3 ＇sulfo-Lewis, Annexin-A5, MK and PTN and s IL-2R levels of the open surgery group were higher than those of the laparoscopic group（P〈0.05）. The concentrations of HAb18 G, CD147, Lgr5, CD40, CD34, D2- 40 and m RNA in the serum were significantly lower than those in the laparoscopic group（P〈0.05）. Conclusion Laparoscopic surgery could not only inhibit the tumor growth,but also can reduce the release of tumor markers and increase the concentration of immune molecules, which is worthy of clinical application.