腹腔镜对胃癌患者T细胞以及氧化应激和炎症因子的影响

Impact of laparoscopy on T cells, oxidative stress, IL2 and soluble receptor in gastric cancer patients

目的观察腹腔镜和开腹胃癌根治术的疗效及对患者CD4+CD25+T细胞、氧化应激、白细胞介素-2(IL-2)及其可溶性受体的影响。方法选取该院2009年11月-2012年11月收治的60例腹腔镜下胃癌根治术(LRG组)治疗的胃癌患者和60例开腹胃癌根治术(ORG组)治疗的胃癌患者作为研究对象,对比两种手术方式的效果及对患者CD4+CD25+T细胞、氧化应激、IL-2及其可溶性受体的影响。结果 LRG组患者手术时间、出血量、淋巴结清除数分别为(285.8±98.6)min、(343.3±125.5)ml、(7.8±1.2)枚,各指标均明显优于ORG组患者,LRG组患者吻合口漏、肠梗阻、胆道损伤和肺部感染分别为1、1、0和0例与ORG组对比无差异,手术后丙二醛(MDA)以及晚期氧化蛋白产物(AOPP)均较前上升,但LRG组低于ORG组患者;术后抗氧化物谷胱甘肽过氧化物酶(GSH-PX)和超氧化物歧化酶(SOD)较前下降,但LRG组高于ORG组,治疗后LRG组患者CD4+CD25+T细胞含量上升且明显高于ORG组,治疗后两组患者IL-2、白细胞介素-2可溶性受体(s-IL-2R)较前上升,LRG组患者IL-2、s-IL-2R水平分别为(32.6±4.2)和(23.6±4.6)μg/ml明显低于ORG组患者,差异有统计学意义(P<0.05),两组患者术后1、2、3和5年生存率对比无差异。结论腹腔镜与开腹手术治疗胃癌具有等效性,而且有助于稳定T细胞、抑制氧化应激和炎症因子活化。

Objective To observe the curative effect of laparoscopic and open radical gastrectomy for gastric cancer patients and the impact on patients'CD4+CD25+T cells,oxidative stress,IL-2and soluble receptors.Methods120cases from November2009to September2012were enrolled.60patients received laparascopic radical gastrectomy(LRG group)and60patients received open radical gastrectomy(ORG group)as research object,the two kinds of operation mode were compared and the impact of operation on patients'CD4+cells,oxidative stress,CD25+T IL-2and its soluble receptor were recorded.Results The operation time,blood loss,number of lymph node dissection n LRG group were(285.8±98.6),(343.3±125.5),(7.8±1.2),all the indexes were significantly superior to the ORG group and LRG group of patients with anastomotic leakage,intestinal obstruction,bile duct injury and pulmonary infection were1,1,0,and0cases no difference in ORG group than MDA and AOPP,after the operation were increased,but the LRG group was lower than that of ORG group patients;postoperative antioxidant GSH-PX,SOD decreased,but LRG was higher than that of ORG group,and LRG group after treatment increased CD4+CD25+T cells in patients with the content of IL-2of two groups after treatment,s-IL-2R increased than before LRG,group IL-2,s-IL-2R levels were(32.6±4.2)and(23.6±4.6)μg/ml was significantly lower than that of ORG group,P<0.05,There was no difference in the1,2,3,and5year survival rates between the two groups of patients.Conclusion Laparoscopic and open surgery for gastric cancer is equivalent,but also help to stabilize Tcells,inhibit oxidative stress and inflammatory factors.