腹腔镜胃癌根治术对患者的疗效及对CEA、CA199的影响

Efficacy of Laparoscopic Radical Gastrectomy for Gastric Cancer and Its Effect on CEA and CA199

目的研究腹腔镜胃癌根治术(LRG)对患者的疗效及对癌胚抗原(CEA)、血清糖类抗原199(CA199)的影响。方法选择行手术治疗的胃癌患者185例,根据手术方案的不同将患者分成观察组(LRG术式)95例及对照组(传统的开腹术式)90例,对比两组手术疗效指标,不同时期的白细胞介素-2(IL-2)及白细胞介素-6(IL-6)炎症因子水平,CEA及CA199水平,以及术后并发症的发生情况。结果观察组除淋巴结清扫数目较对照组无明显差异外,其切口长度和手术时间,及术中出血量和排气时间,以及住院时间均分别明显优于对照组,差异均有统计学意义(P<0.05)。术后5d两组的IL-2及IL-6水平明显高于术前,但观察组的IL-2及IL-6水平仍明显低于对照组,差异均有统计学意义(P<0.05)。两组术后5 d的CEA及CA199水平相比差异不显著(P>0.05),但均明显低于术前,差异有统计学意义(P<0.05)。观察组术后并发症的总发生率为2.11%,明显低于对照组的8.89%,差异有统计学意义(P<0.05)。结论应用LRG术式治疗胃癌患者可获得较好的疗效,同时还可有效降低CEA及CA199的水平,安全性较高,值得推广。

Objective To study the efficacy of laparoscopic radical gastrectomy for gastric cancer and its effect on CEA and CA199. Methods 185 patients with gastric cancer who underwent surgery were studied. According to the different surgical procedures,the patients were divided into the observation group（ LRG operation） 95 cases and the control group（ traditional open surgery） 90 cases,the curative effect index of the 2 groups,the levels of IL-2 and IL-6 inflammatory factors,CEA and CA199 levels in different periods,and the occurrence of postoperative complications were compared. Results The number of lymph node of the 2 groups had no obvious difference,the incision length and the operation time,bleeding volume and exhaust time and during the operation,and hospitalization time of the observation group were significantly better than the control group,the differences were statistically significant（ P〈0. 05）. The level of IL-2 and IL-6 of 5 d after operation in the 2 groups was significantly higher than that before operation,but the level of IL-2 and IL-6 in the observation group was still significantly lower than that of the control group,and the differences were statistically significant（ P〈0. 05）. There was no significant difference in the level of CEA and CA199 between the 2 groups（ P〉0. 05）,but the difference was significantly lower than that before the operation,the difference was statistically significant（ P〈0. 05）. The total incidence rate of postoperative complications in the observation group was 2. 11%,which was significantly lower than that of the control group,8. 89%,and the difference was statistically significant（ P〈0. 05）. Conclusion LRG in the treatment of gastric cancer patients can get better curative effect,and can effectively reduce the level of CEA and CA199,with high safety,it is worth promoting.