早期非小细胞肺癌胸腔镜与开胸术后血清CRP及TNF-α、IL-6的对比

Postoperative Serum CRP,TNF-α and IL-6 Levels in Patients with Early-Stage Non-Small Cell Lung Cancer:A Comparison of Thoracoscopic Surgery and Thoracotomy

目的比较传统开胸与胸腔镜肺癌根治术后,早期非小细胞肺癌(NSCLC)患者血清中炎症因子(CRP)及细胞因子(TNF-α、IL-6)水平的差异。方法选取78例NSCLC患者,分别行传统开胸(47例,开胸组)与胸腔镜肺癌根治术(31例,胸腔镜组)。于术前及术后4h、1d、2d、3d、7d抽取静脉血标本,使用超敏CPR分析测定法测定CRP,用双抗体夹心ELISA法测定TNF-α、IL-6。结果 2组术后4h、1d、2d及3dCPR水平差异有统计学意义(P<0.05),术后4h及1dIL-6水平差异有统计学意义(P<0.05);CPR、IL-6水平分别在术后1、3d恢复正常,但IL-6的变化幅度较CRP大;术前及术后2组TNF-α水平差异无统计学意义(P>0.05)。结论胸腔镜肺癌根治术较传统开胸,可减少患者术后炎症因子及细胞因子的释放,从而减少患者机体的炎症反应及免疫应答反应。

Objective To compare the serum levels of C-reactive protein（CRP）,tumor necrosis factor-α（TNF-α）and interleukin-6（IL-6）between thoracoscopic surgery and thoracotomy for early-stage non-small cell lung cancer（NSCLC）.Methods Seventy-eight patients with NSCLC were assigned to receive traditional thoracotomy（thoracotomy group,n=47）or radical thoracoscopic surgery（thoracoscopy group,n=31）.Venous blood samples were collected before operation and 4hour,1day,2days,3days and 7days after operation.Serum CRP levels were detected by highsensitive CRP analysis,and serum TNF-αand IL-6levels were measured by double-antibody sandwich ELISA.Results There were significant differences between the two groups in serum CPR levels on postoperative hour 4,day 1,day 2and day 3,as well as in serum IL-6levels on postoperative hour 4and day 1（P〈0.05）.The CPR and IL-6decreased to normal levels on postoperative day 3and day 1,respectively.However,the change in IL-6was greater than that in CRP.No significant differences in TNF-αlevels were found between the two groups before and after operation（P〉0.05）.Conclusion Compared with traditional thoracotomy,radical thoracoscopic surgery can reduce inflammatory and immune responses through inhibiting the release of inflammatory factors and cytokines in patients with NSCLC.