腹腔镜直肠癌根治术对直肠癌患者循环肿瘤细胞及疼痛相关因子的影响

Effect of Laparoscopic Rectal Cancer Radical Operation on Circulating Tumor Cells and Pain Related Factors in Patients with Rectal Cancer

目的:研究腹腔镜直肠癌根治术对直肠癌患者循环肿瘤细胞(CTC)及疼痛相关因子的影响。方法:选取2020年1月—2022年3月南京市江宁医院收治的81例直肠癌患者。根据计算机分组法将其分为对照组(n=40)和观察组(n=41)。对照组采用传统开腹直肠癌根治术治疗,观察组采用腹腔镜直肠癌根治术治疗。比较两组围手术期指标,术前、随访结束后CTC计数,术前、术后1 d疼痛相关因子。结果:两组手术时间、淋巴结清扫数比较差异无统计学意义(P>0.05),观察组术中出血量少于对照组,差异有统计学意义(P<0.05)。随访结束后,两组CTC计数比较差异无统计学意义(P>0.05)。术后1 d,两组神经肽Y(NPY)、前列腺素E2(PGE2)、神经生长因子(NGF)水平均升高,但观察组NPY、PGE2、NGF水平均低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜和开腹直肠癌根治术效果相似,均可清扫淋巴结,降低术后CTC计数,但腹腔镜手术术中出血量较少,在抑制患者术后疼痛因子表达方面更具优势。

Objective:To study the effect of laparoscopic rectal cancer radical operation on circulating tumor cells(CTC)and pain related factors in patients with rectal cancer.Method:A total of 81 patients with rectal cancer admitted to Nanjing Jiangning Hospital from January 2020 to March 2022 were selected.They were divided into control group(n=40)and observation group(n=41)according to the computer grouping method.The control group was treated with traditional open radical operation of rectal cancer,and the observation group was treated with laparoscopic rectal cancer radical operation.The perioperative indexes,CTC count before operation and after follow-up,and pain related factors before operation and 1 d after operation were compared between the two groups.Result:There were no significant differences in the operation time and number of lymph nodes dissection between the two groups(P>0.05),and the intraoperative blood loss volume in the observation group was less than that in the control group,the difference was statistically significant(P<0.05).After follow-up,there was no significant difference in CTC count between the two groups(P>0.05).At 1 d after operation,the levels of neuropeptide Y(NPY),prostaglandin E2(PGE2)and nerve growth factor(NGF)in both groups were increased,but the levels of NPY,PGE2 and NGF in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Laparoscopic and open rectal cancer radical operation have similar effects,both can remove lymph nodes and reduce postoperative CTC count.However,laparoscopic operation has less intraoperative blood loss volume and more advantages in inhibiting the expression of postoperative pain factors in patients.