不同术式治疗胃癌的效果及对外周血CTC水平的影响

Effects of different surgical methods in treatment of gastric cancer and impacts on CTC levels in PB

目的比较分析不同术式治疗胃癌的效果及对外周血循环肿瘤细胞(CTC)水平的影响。方法根据不同术式将178例胃癌患者分为治疗组(95例,腹腔镜下胃癌D2根治术)与对照组(83例,开腹D2根治术),比较两组围手术期指标及手术前后外周血CTC水平。结果手术时间上,治疗组显著长于对照组(P<0.05);术中出血量、肛门排气时间、住院时间及并发症总发生率比较,治疗组均显著少于对照组(P<0.05);两组术后3 d CTC检出率比术前均显著降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论腹腔镜与开腹根治性切除术治疗胃癌疗效相当,二者均能明显降低患者外周血CTC水平,但腹腔镜相比开腹手术具有术中出血量少、术后并发症少的优点。

Objective To compare the effects of different surgical methods in the treatment of gastric cancer and impacts on the circulating tumor cells （CTC） levels in peripheral blood （PB）. Methods A total of 178 patients with gastric cancer were divided into a treatment group （n=95, laparoscopic D2 radical gastrectomy for gastric cancer） and a control group （n=83, laparotomy D2 radical gastrectomy） according to different surgical methods. The perioperative indexes and the preoperative and postoperative CTC levels in PB between the two groups were compared, Results The duration of operation in the treatment group was significantly longer than that in the control group （P 〈 0.05）; the intraoperative amount of bleeding, the time of passage of gas by anus, the length of stay （LOS） and the total incidence of complications in the treatment group were significantly shorter or lower than those in the control group （P 〈 0.05）; the detection rate of CTC on the third day after the operation was significantly lower than that before the operation （P 〈 0.05）, but there was no statistical difference between the two groups （P 〉 0.05）. Conclusion Laparoscopic and laparotomy radical gastrectomy have equivalent effects in the treatment of gastric cancer and can lower the CTC levels in PB, but laparoscopic surgery has less intraoperative amount of bleeding and fewer postoperative complications than laparotomy.