完全腹腔镜术治疗老年原发性肝细胞癌的临床疗效及对血清VEGF TGF-α SICAM-1的影响

Effect of Total Laparoscopy on Serum Levels of VEGF TGF-alpha and SICAM-1 in Elderly Patients with Primary Hepatocellular Carcinoma

目的:分析完全腹腔镜术治疗老年原发性肝细胞癌的临床疗效及对血清血管内皮生长因子(VEGF)、转化生长因子-α(TGF-α)、可溶性细胞问黏附分子-1(SICAM-1)的影响。方法:84例老年原发性肝细胞癌患者按简单随机数字表法分为44例对照组和40例研究组。对照组予以开腹肝切除术治疗,研究组予以完全腹腔镜术治疗。比较两组手术指标,血清VEGF,TGF-α,SICAM-1水平,肝功能,并发症和随访情况。结果:两组手术时间比较无统计学差异(P>0.05);研究组术中失血量、进食时间、术后下床时间及住院时间均少于对照组(P<0.05)。术后1个月、3个月,两组血清VEGF、TGF-α、SICAM-1水平均低于术前(P <0.05),但组间变化程度比较无统计学差异(P>0.05)。术后3d、7d,两组肝功能指标均高于术前(P<0.05),但研究组变化幅度更小,两组比较有统计学差异(P<0.05)。两组并发症发生率比较无统计学差异(P>0.05)。两组1年复发率、2年复发率、1年生存率及2年生存率比较无统计学差异(P>0.05)。结论:完全腹腔镜术治疗老年原发性肝细胞癌能够降低血清VEGF、TGF-α及SICAM-1水平,达到和开腹手术相似的安全性及生存率,且在手术创伤性、肝功能影响等方面更具优势。

Objective:To analyze the clinical effect of complete laparoscopy in the treatment of elderly patients with primary hepatocellular carcinoma and its effects on serum vascular endothelial growth factor(VEGF),transforming growth factor-alpha(TGF-alpha),soluble intercellular adhesion molecule-1(SICAM-1).Methods:84 patients with primary hepatocellular carcinoma according to simple random number table method were divided into 44 control group and 40 research group.control group was treated with open hepatectomy,and the research group was treated with complete laparoscopi.surgical index,serum VEGF,TGF-α,SICAM-1,liver function,complications and follow-up in both group were compared.Results:There was no significant difference in operative time between the two groups(P>0.05).1 months and 3 months after operation,the blood loss,feeding time,getting out of bed and hospitalization time in the study group were less than those in the control group(P<0.05).Three days and seven days after operation,the liver function indexes of the two groups were higher than those before operation(P<0.05),but the change range of the study group was smaller,and there was statistical difference between the two groups(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).There was no significant difference in 1-year recurrence rate,2-year recurrence rate,1-year survival rate and 2-year survival rate between the two groups(P>0.05).Conclusion:Complete laparoscopic treatment of elderly patients with primary hepatocellular carcinoma can reduce serum levels of vascular endothelial growth factor,TGF-alpha and SICAM-1,achieve the same safety and survival rate as open surgery,and have more advantages in surgical trauma and liver function.