腹腔镜CO_2气腹对大肠癌血液转移的影响
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摘要
目的探讨腹腔镜结直肠癌手术时建立CO_2气腹对肿瘤细胞血液转移的影响。方法选取60例经病理学确诊为结直肠癌患者,将患者按照随机数字表法分为腹腔镜组和开腹组。抽取2组患者术前、术中、术后的外周血样,采用巢式RT-PCR法检测血样中细胞角蛋白20(CK20)的表达,分析不同手术方式对患者外周血肿瘤细胞转移的影响。结果 2组患者外周血CK20mRNA术前、术中、术后不同时间组内、组间阳性表达率比较,差异均无统计学意义(P>0.05)。2组患者的3年生存率比较无显著差异(P>0.05)。结论腹腔镜CO_2气腹行腹腔镜结直肠癌切除手术不增加患者外周血CK20mRNA的阳性表达率。
Objective To explore the influence of laparoscopic CO_2 pneumoperitoneum on blood metastasis of colorectal cancer. Methods Sixty colorectal cancer patients were randomly divided into laparoscopic surgery group and open surgery group. RT-PCR was used to detect the expressions of CK20 mRNA before treatment,in operation and after operation,and effect of different surgical methods on the metastasis of tumor cells in peripheral blood was analyzed. Results There were no significant differences in positive expression of CK20 mRNA before treatment,in operation and after operation between two groups( P > 0. 05). There was no significant difference in 3-year survival rate between the two groups( P > 0. 05). Conclusion Laparoscopic CO_2 pneumoperitoneum does not increase the positive rate of CK20 mRNA in peripheral blood in treatment of patients with laparoscopic resection of colorectal cancer.
Objective To explore the influence of laparoscopic CO_2 pneumoperitoneum on blood metastasis of colorectal cancer. Methods Sixty colorectal cancer patients were randomly divided into laparoscopic surgery group and open surgery group. RT-PCR was used to detect the expressions of CK20 mRNA before treatment,in operation and after operation,and effect of different surgical methods on the metastasis of tumor cells in peripheral blood was analyzed. Results There were no significant differences in positive expression of CK20 mRNA before treatment,in operation and after operation between two groups( P > 0. 05). There was no significant difference in 3-year survival rate between the two groups( P > 0. 05). Conclusion Laparoscopic CO_2 pneumoperitoneum does not increase the positive rate of CK20 mRNA in peripheral blood in treatment of patients with laparoscopic resection of colorectal cancer.
引文
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[17]王莉,任秀英,辛华,等.大肠癌中P53、nm23-H1和MMP-9基因的表达[J].黑龙江医药科学,2016,39(6):42-43.
[18]蒋华锋,应晓江,陈洪亮,等.大肠癌中血管内皮生长因子-A的表达与淋巴管密度、微血管密度的关系研究[J].中华全科医学,2016,14(11):1870-1872.
[2]董嘉天,程明荣,徐宏智.CK20在检测结直肠癌淋巴结微转移中的临床意义[J].中国临床医学,2010,17(3):351-353.
[3]董纯秀,彭波,刘月,等.腹腔镜结直肠癌根治术对血循环微转移影响的研究[J].重庆医学,2010,39(9):1056-1058.
[4]江志伟,黎介寿.结直肠癌手术腹腔镜或开腹术式选择的争论[J].中国实用外科杂志,2008,28(6):453-455.
[5]郑华民.正确评价腹腔镜在直肠癌外科治疗中的地位[J].中华外科杂志,2009,47(13):986-970.
[6]尹慕军,叶颖江,姜可伟,等.腹腔镜结直肠癌手术临床疗效探讨[J].中国医药,2010,5(1):60-62.
[7]颜登国,张汝一,甄运寰,等.结直肠癌患者血液中CK20 mRNA的表达[J].中国普外基础与临床杂志,2011,18(2):164-167.
[8]陈义荣,张春锋,石书宏,等.腹腔镜手术对大肠癌术后癌细胞转移的影响[J].工企医刊,2014,27(6):1163-1165.
[9]向德雨,秦章禄,郭朝阳,等.不同二氧化碳气腹压对腹腔镜结直肠癌手术患者腹腔微转移的影响[J].中国基层医药,2016,23(5):774-776,777.
[10]于金海,孙东辉,肖大雷,等.腹腔镜手术CO2气腹对进展期胃癌患者腹腔脱落癌细胞及预后的影响[J].临床与病理杂志,2015(z1):52-52.
[11]黄仁峰.CO2气腹下结直肠癌细胞MMP-7表达的研究[D].南华大学,2014.
[12]刘新兰,李亦功,魏建敏,等.Ang-2、Tie-2和VEGFR-2表达在大肠癌血管生成和预后中的作用[J].南方医科大学学报,2012,32(11):1658-1662.
[13]王成,郝立群.大肠癌外周血循环肿瘤细胞数的检测及临床意义[J].实用临床医药杂志,2014,18(23):35-38.
[14]钟志凤,杜金林,张天明,等.大肠癌中Heregulin、Erb B-2及MMP-7的相关性研究及意义[J].中华全科医学,2015,13(6):872-874.
[15]岳昌武,吕玉红,周昕,等.Colo205来源的大肠癌始动细胞锌指蛋白表达谱变化分析[J].第三军医大学学报,2014,36(16):1754-1757.
[16]樊善继,徐海帆,胡泽成,等.大肠癌患者组织多项基质金属蛋白、VEGF-C、VEGF-D、Ets-1、CD44v6及VEGFR-3的变化[J].海南医学院学报,2014,20(2):177-179.
[17]王莉,任秀英,辛华,等.大肠癌中P53、nm23-H1和MMP-9基因的表达[J].黑龙江医药科学,2016,39(6):42-43.
[18]蒋华锋,应晓江,陈洪亮,等.大肠癌中血管内皮生长因子-A的表达与淋巴管密度、微血管密度的关系研究[J].中华全科医学,2016,14(11):1870-1872.