全胸腔镜肺叶切除术对早期非小细胞肺癌患者miR-25、miR-29A、miR-126及T淋巴细胞亚群的影响

Effects of Total Thoracoscopic Lobectomy on miR-25,miR-29A,miR-126 and T Lymphocyte Subsets in Patients with Early Non-small Cell Lung Cancer

目的探讨对早期非小细胞肺癌(NSCLC)患者采用全胸腔镜肺叶切除术(VATS)治疗的效果。方法采用随机数字表法将NSCLC患者80例分为2组,各40例,对照组采用开胸手术,观察组采用VATS。比较两组围术期指标、微小核糖核(miR)相关指标及免疫功能指标,并随访1年,统计两组总生存期及无进展生存期。结果观察组住院时间短于对照组,术后引流量及术中出血量均少于对照组,有统计学差异(P<0.05);两组手术时间、淋巴结清扫数目比较,无统计学差异(P>0.05);两组术后miR-25、miR-29A、miR-126水平均较术前升高,且观察组高于对照组,有统计学差异(P<0.05);两组术后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较术前降低,但观察组高于对照组,两组CD8^(+)水平均较术前升高,但观察组低于对照组,有统计学差异(P<0.05);随访1年,两组无进展生存期及总生存期比较,无统计学差异(P>0.05)。结论在早期NSCLC患者中采用VATS治疗创伤更小,可有效调节血浆miR-25、miR-29A、miR-126水平,对免疫功能影响小,有利于患者术后尽早恢复。

Objective To investigate the effect of total Thoracoscopy lobectomy(VATS)for early non-small cell lung cancer(NSCLC).Methods 80 NSCLC patients were divided into 2 groups using a random number table method,with 40 patients in each group.The control group underwent thoracotomy,while the observation group underwent VATS.Compare the perioperative indicators,miR related indicators,and immune function indicators between the 2 groups,and follow up for 1 year to calculate the total survival and progression free survival of the 2 groups.Results The hospitalization time of the observation group was shorter than that of the control group,and the postoperative drainage volume and intraoperative bleeding volume were lower than those of the control group,with statistical differences(P<0.05);There was no statistically significant difference in surgical time and number of lymph node dissection between the 2 groups(P>0.05);The levels of miR-25,miR-29A,and miR-126 in the 2 groups increased after surgery compared to before,and the observation group was higher than the control group,with a statistical difference(P<0.05);The postoperative levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in both groups decreased compared to before surgery,but the observation group was higher than the control group.The CD8^(+)levels in both groups increased compared to before surgery,but the observation group was lower than the control group,with a statistical difference(P<0.05);After 1-year follow-up,there was no statistically significant difference in the progression free survival and overall survival between the 2 groups(P>0.05).Conclusion The use of VATS in early NSCLC patients has less trauma,can effectively regulate plasma levels of miR-25,miR-29A,and miR-126,and has little impact on immune function,which is conducive to early postoperative recovery of patients.