前入路肝切除术对肝细胞肝癌患者肿瘤标志物和炎症指标的影响

Effect of anterior approach hepatectomy on tumor markers and inflammatory indicators in patients with hepatocellular carcinoma

目的 探讨前入路肝切除术对肝细胞肝癌(HCC)患者肿瘤标志物和炎症指标的影响。方法 根据手术入路的不同将104例HCC患者分为对照组(n=52,传统入路肝切除术)和观察组(n=52,前入路肝切除术)。比较两组患者的手术相关指标、肿瘤标志物[癌胚抗原(CEA)、甲胎蛋白(AFP)]水平、炎症指标[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、中性粒细胞与淋巴细胞比值(NLR)]及并发症发生情况。结果 观察组患者术中出血量、血浆输注量、红细胞输注量均少于对照组,住院时间短于对照组,差异均有统计学意(P﹤0.05)。手术后,两组患者CEA、AFP水平均明显低于本组手术前,观察组患者CEA、AFP水平均明显低于对照组,差异均有统计学意义(P﹤0.01)。手术后,两组患者IL-6、IL-8、TNF-α水平及NLR均明显高于本组手术前,观察组患者IL-6、IL-8、TNF-α水平及NLR均明显低于对照组,差异均有统计学意义(P﹤0.01)。观察组患者并发症总发生率低于对照组(P﹤0.05)。结论 前入路肝切除术对HCC患者肝脏的损伤较小,可减少术中液体输注量,降低肿瘤标志物水平,减轻炎症反应,提高手术安全性。

Objective To investigate the effect of anterior approach hepatectomy on tumor markers and inflammatory indicators in patients with hepatocellular carcinoma(HCC).Method A total of 104 HCC patients were divided into control group(n=52,traditional approach hepatectomy) and observation group(n=52,anterior approach hepatectomy) according to different surgical approaches.The surgery-related indicators,tumor marker [carcinoembryonic antigen(CEA),α-fetoprotein(AFP)] levels,inflammatory indicators [interleukin-6(IL-6),interleukin-8( IL-8),tumor necrosis factor-α(TNF-α),neutrophil-to-lymphocyte ratio(NLR)],and the occurrence of complications were compared between the two groups.Result The intraoperative blood loss,plasma transfusion volume,and red blood cell transfusion volume of the observation group were significantly less than those of the control group,hospitalization time was shorter than that of the control group,and the differences were statistically significant(P<0.05).After the surgery,the levels of CEA and AFP in the two groups were significantly lower than those before the surgery,the levels of CEA and AFP in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).After the surgery,the levels of IL-6,IL-8,TNF-α,and NLR in the two groups were significantly higher than those before the surgery,the levels of IL-6,IL-8,TNF-α,and NLR in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.01).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion The employment of anterior approach hepatectomy for HCC patients could cause less damage to the liver,reduce intraoperative fluid infusion,reduce tumor marker levels and inflammatory response,and improve surgical safety.