胸腔镜肺叶切除术与开胸肺叶切除术对肺癌患者miR-498水平及Notch-1蛋白表达的影响

Effects of thoracoscopic lobectomy and thoracotomy lobectomy on miR-498 level and Notch-1 protein expression in patients with lung cancer

目的探究胸腔镜肺叶切除术与开胸肺叶切除术对肺癌患者miR-498水平及Notch-1蛋白表达的影响。方法回顾性分析2020年6月至2021年5月于我院接受胸腔镜肺叶切除术与开胸肺叶切除术治疗的肺癌患者的临床资料,根据样本量计算公式最终纳入120例肺癌患者,分为胸腔镜组和开胸组,各60例。胸腔镜组给予胸腔镜肺叶切除术,开胸组给予开胸肺叶切除术。比较两组的手术相关指标、miR-498水平、应激反应指标及Notch-1蛋白表达情况。结果胸腔镜组的手术时间、引流管留置时间短于开胸组,术中出血量、引流量少于开胸组,差异具有统计学意义(P<0.05)。术前、术后3 d,两组的miR-498水平比较,差异无统计学意义(P>0.05);术后3 d,两组的miR-498水平高于术前,差异具有统计学意义(P<0.05)。术后3 d,两组的皮质醇(Cor)、前列腺素E_(2)(PGE_(2))水平均升高,但胸腔镜组低于开胸组,差异具有统计学意义(P<0.05)。手术时、术后6个月,两组的Notch-1蛋白表达阳性率比较,差异无统计学意义(P>0.05);术后6个月,两组的Notch-1蛋白表达阳性率均降低,差异具有统计学意义(P<0.05)。结论胸腔镜肺叶切除术为微创手术,其对肺癌患者造成的影响较小,患者应激反应更轻,但对血清miR-498水平、肺癌组织中的Notch-1蛋白表达情况与开胸肺叶切除术近似。

Objective To explore the effects of thoracoscopic lobectomy and thoracotomy lobectomy on miR-498 level and Notch-1 protein expression in patients with lung cancer. Methods The clinical data of patients with lung cancer who underwent thoracoscopic lobectomy and thoracotomy lobectomy in our hospital from June 2020 to May 2021 were retrospectively analyzed. According to the calculation formula of sample size, 120 patients with lung cancer were finally included and divided into thoracoscopic group and thoracotomy group, with 60 cases in each group. The thoracoscopic group was given thoracoscopic lobectomy, and the thoracotomy group was given thoracotomy lobectomy. The operation related indexes, miR-498 level, stress response indexes and Notch-1 protein expression were compared between the two groups. Results The operation time and drainage tube indwelling time of the thoracoscopic group were shorter than those of the thoracotomy group, the intraoperative blood loss and drainage volume were less than those of the thoracotomy group, and the differences were statistically significant(P<0.05). There was no significant difference in miR-498 level between the two groups before and 3 d after operation(P>0.05);at 3 d after operation, the level of miR-498 in the two groups was higher than that before operation, and the difference was statistically significant(P <0.05). At 3 d after operation, the levels of cortisol(Cor) and prostaglandin E_(2)(PGE_(2)) in the two groups increased, but those in the thoracoscopic group were lower than the thoracotomy group, and the differences were statistically significant(P<0.05). There was no significant difference in the positive rate of Notch-1 protein expression between the two groups at operation and 6 months after operation(P>0.05);at 6months after operation, the positive rate of Notch-1 protein expression in the two groups decreased, and the difference was statistically significant(P <0.05). Conclusion Thoracoscopic lobectomy is a minimally invasive surgery, which has less impact on patients with lung cancer and less stress response. However, the level of serum miR-498 and the expression of Notch-1 protein in lung cancer tissues are similar to those of thoracotomy lobectomy.