摘要
目的 探讨腹腔镜胃癌根治术对老年胃癌患者免疫功能及预后的影响。方法 依据手术方式的不同将80例老年胃癌患者分为开腹组和腹腔镜组,每组40例,开腹组患者给予开腹胃癌根治术,腹腔镜组患者给予腹腔镜胃癌根治术。比较两组患者围手术期指标、免疫功能指标、血清肿瘤标志物[癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)]及预后情况。结果 腹腔镜组患者术中出血量明显少于开腹组,半流质饮食时间、下床活动时间、住院时间均明显短于开腹组,差异均有统计学意义(P﹤0.01)。手术后,两组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均低于本组手术前,腹腔镜组患者CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于开腹组,差异均有统计学意义(P﹤0.05)。手术后,两组患者CEA、CYFRA21-1、CA125水平均低于本组手术前,且腹腔镜组患者CEA、CYFRA21-1、CA125水平均低于开腹组,差异均有统计学意义(P﹤0.05)。术后2年,腹腔镜组患者的复发率和死亡率均低于开腹组,差异均有统计学意义(P﹤0.05)。结论 腹腔镜胃癌根治术治疗老年胃癌患者具有创伤小、恢复快的优点,可降低对患者免疫功能的影响,改善预后。
Objective To explore the effect of laparoscopic radical gastrectomy on immune function and prognosis in elderly patients with gastric cancer. Method A total of 80 elderly patients with gastric cancer were divided into laparotomy group(n=40, received open laparotomy) and laparoscopic group(n=40, received laparoscopic radical gastrectomy) according to different surgical methods. The perioperative indexes, immune function indexes, serum tumor markers [carcinoembryonic antigen(CEA), cyto-keratin 19 fragment antigen 21-1(CYFRA21-1), carbohydrate antigen 125(CA125)], and prognosis were compared between the two groups. Result The amount of intraoperative bleeding in the laparoscopic group was significantly less than that in the laparotomy group, and the semi-fluid diet time, time of getting out of bed activity and hospitalization time were significantly shorter than those in the laparotomy group, the differences were statistically significant(P<0.01). After the operation, the levels of CD3^(+), CD4^(+)and CD4^(+)/CD8^(+)in the two groups were lower than those before the operation, and the levels of CD3^(+), CD4^(+)and CD4^(+)/CD8^(+)in the laparoscopic group were higher than those in the laparotomy group, the differences were statistically significant(P<0.05). After surgery, the levels of CEA, CYFRA21-1 and CA125 in the two groups were lower than those before surgery, and the levels of CEA, CYFRA21-1 and CA125 in the laparoscopic group were lower than those in the laparotomy group, the differences were statistically significant(P<0.05). Two years after operation, the recurrence rate and mortality rate of patients in the laparoscopic group were lower than those in the laparotomy group, and the differences were statistically significant(P<0.05). Conclusion Laparoscopic radical gastrectomy for elderly patients with gastric cancer has the advantages of less trauma and faster recovery, which can reduce the effect on immunity and improve prognosis.
作者
马艳飞
韩轮
MA Yanfei;HAN Lun(Department of General Surgery,the First Hospital of Yulin,Yulin 718000,Shaanxi,China)
出处
《癌症进展》
2023年第2期177-179,183,共4页
Oncology Progress
关键词
胃癌
腹腔镜胃癌根治术
肿瘤标志物
免疫功能
gastric cancer
laparoscopic radical gastrectomy
tumor marker
immune function