单孔胸腔镜肺段与肺叶切除对非小细胞肺癌患者疗效和T淋巴细胞亚群及炎症因子水平的影响

Effects of single-port thoracoscopic pulmonary segmentectomy and pulmonary lobectomy on the efficacy and T lymphocyte subsets and inflammatory factors in patients with non-small cell lung cancer

目的探讨单孔胸腔镜肺段与肺叶切除对非小细胞肺癌(NSCLC)患者疗效、T淋巴细胞亚群、炎症因子水平的影响。方法选取2018年2月至2020年10月于本院行单孔胸腔镜治疗的60例NSCLC患者作为研究对象,根据手术方式不同分为肺段组与肺叶组,每组30例。肺段组接受单孔胸腔镜肺段切除术治疗,肺叶组接受单孔胸腔镜肺叶切除术治疗,比较两组围手术期指标、T淋巴细胞亚群、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、C反应蛋白(CRP)]。结果两组手术时间、术中出血量、术后引流时间比较差异无统计学意义;肺段组淋巴结清扫数、淋巴结清扫站数均少于肺叶组,差异有统计学意义(P<0.05)。术后5 d,两组CD3^(+)、CD4^(+)水平均高于术前1 d,CD8^(+)水平均低于术前1 d,且肺段组CD3^(+)、CD4^(+)水平均高于肺叶组,CD8^(+)水平低于肺叶组,差异有统计学意义(P<0.05)。术后5 d,两组TNF-α、IL-8、CRP水平均高于术前1 d,但肺段组低于肺叶组,差异有统计学意义(P<0.05)。结论单孔胸腔镜肺段与肺叶切除治疗NSCLC患者疗效相当,但肺段切除术能有效缓解患者免疫抑制状态,降低其炎症因子水平,临床应用价值较高。

Objective To investigate the effects of single-port thoracoscopic pulmonary segmentectomy and pulmonary lobectomy on the efficacy,T lymphocyte subsets and inflammatory factors in patients with non-small cell lung cancer(NSCLC).Methods 60 patients with NSCLC who underwent single-aperture thoracoscopic treatment treated in our hospital from February 2018 to October 2020 were selected as the study subjects,and they were divided into the lung segment group and the lung lobe group according to the different surgical methods,with 30 cases in each group.The lung segment group was treated with single-port thoracoscopic pulmonary segmentectomy,and the lung lobe group was treated with single-port thoracoscopic pulmonary lobectomy,perioperative indicators,T lymphocyte subsets,inflammatory factors(tumor necrosis factor-α[TNF-α],interleukin-8[IL-8],C-reactive protein[CRP])were compared between the two groups.Results There were no significant difference in operation time,intraoperative blood loss and postoperative drainage time between the two groups;the number of lymph node dissection and lymph node dissection stations in the lung segment group were less than those in the lung lobe group,and the differences were statistically significant(P<0.05).At 5 d after operation,the levels of CD3^(+)and CD4^(+)in the two groups were higher than those at 1 d before operation,and the levels of CD8^(+)were lower than those at 1 d before operation,and the levels of CD3^(+)and CD4^(+)in the lung segment group were higher than those in the lung lobe group,and the level of CD8^(+)was lower than that in the lung lobe group,and the differences were statistically significant(P<0.05).At 5 d after operation,the levels of TNF-α,IL-8 and CRP in the two groups were higher than those at 1 day before operation,but those in the lung segment group were lower than those in the lung lobe group,and the differences were statistically significant(P<0.05).Conclusion The curative effect of single-port thoracoscopic pulmonary segmentectomy and pulmonary lobectomy in the treatment of NSCLC patients is equivalent,but segmentectomy can more effectively alleviate the immunosuppressive state of patients and reduce the level of inflammatory factors,which has high clinical application value.