不同手术方式对原发性肝癌患者炎症因子及T淋巴细胞亚群的影响

Effects of Different Surgical Methods on Inflammatory Factors and T Lymphocyte Subsets in Patients with Primary Liver Cancer

目的探讨不同手术方式对原发性肝癌患者炎症因子及T淋巴细胞亚群的影响。方法回顾性收集2018年1月至2021年11月于商丘市长征人民医院完成手术治疗的105例原发性肝癌患者的病历资料。根据手术治疗方式分为开腹组(52例)和腹腔镜组(53例)。开腹组患者接受开腹肝切除术治疗。腹腔镜组患者接受腹腔镜肝切除术(LH)治疗。比较两组手术指标;比较两组术前1d、术后1周炎症因子和免疫力,包括血清白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平及T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))。结果腹腔镜组切口长度、术后首次进食时间及住院时间均短于开腹组,术中出血量少于开腹组(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05)。术后1周,两组血清IL-8、IL-1β、TNF-α水平均较术前1d升高,但腹腔镜组血清IL-8、IL-1β、TNF-α水平低于开腹组(P<0.05)。术后1周,两组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均较术前1d降低,CD8^(+)水平较术前1d升高(P<0.05);术后1周,腹腔镜组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平高于开腹组,CD8^(+)水平低于开腹组(P<0.05)。结论与开腹肝切除术比较,LH能够减轻原发性肝癌患者术后炎症反应,对免疫功能的影响较小,利于促进患者康复。

Objective To investigate the effects of different surgical methods on inflammatory factors and T lymphocyte subsets in patients with primary liver cancer.Methods The medical records of 105 patients with primary liver cancer who underwent surgical treatment in Shangqiu Changzheng People’s Hospital from January 2018 to November 2021 were collected retrospectively.According to the surgical treatment methods,they were divided into laparotomy group(52 cases)and laparoscope group(53 cases).The patients in laparotomy group received open hepatectomy.The patients in laparoscope group received laparoscopic hepatectomy(LH).The operation indexes of the two groups were compared.The inflammatory factors and immunity,including serum levels of interleukin-8(IL-8),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+) and CD4^(+)/CD8^(+)),were compared between the two groups one day before operation and one week after operation.Results The incision length,the first postoperative eating time and the hospitalization time in laparoscope group were shorter than those in laparotomy group,and the amount of intraoperative bleeding was less than that in laparotomy group(P<0.05).There was no statistical difference in operation time between the two groups(P>0.05).One week after operation,the levels of serum IL-8,IL-1β and TNF-α in both groups were higher than those in the first day before operation,but the levels of serum IL-8,IL-1β and TNF-α in laparoscope group were lower than those in laparotomy group(P<0.05).One week after operation,the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in both groups were lower than those in the first day before operation,while the level of CD8^(+) was higher than that in the first day before operation(P<0.05).One week after operation,the levels of CD3^(+),CD4^(+) and CD4^(+)/CD8^(+) in laparoscope group were higher than those in laparotomy group,while the level of CD8^(+) was lower than that in laparotomy group(P<0.05).Conclusion Compared with open hepatectomy,LH can reduce the postoperative inflammatory response in patients with primary liver cancer,and has lttle effect on immune function,which is conducive to the recovery of patients.