不同CO_2压力状态对卵巢癌SKOV_3细胞增殖、侵袭力影响的实验研究
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摘要
近十年,腹腔镜技术已经取得令人瞩目的成就,同时,腹腔镜恶性肿瘤手术的安全性问题也越来越受到关注。临床上已有腹腔镜肿瘤外科手术后穿刺孔和腹膜肿瘤种植率高于开腹手术、残余肿瘤生长迅速等病例报道。以二氧化碳(carbon dioxide,C02)建立人工气腹是腹腔镜与传统妇科手术方式的主要病理生理差异。但临床报道腹腔镜的相关并发症多与手术操作失误有关,且关于C02与恶性肿瘤细胞的生长和转移关系的细胞学及动物实验报道的结论并不完全一致,甚至有相悖。本研究拟通过模拟实际腹腔镜操作环境,建立不同C02压力梯度,系统观察其对卵巢癌SKOV3细胞体外、体内生长及粘附、转移特性的影响并探讨相关机制,初步评估腹腔镜C02气腹用于妇科恶性肿瘤的安全性。
第一部份不同CO2压力状态对卵巢癌SKOV3细胞体外增殖能力的影响
【目的】通过观察模拟腹腔镜实际操作时的不同C02压力、作用不同时间对卵巢癌SKOV3细胞体外生长、增殖能力的影响,评估C02人工气腹对恶性卵巢肿瘤细胞体外生长、增殖的直接作用并探讨相关机制。
In the last decade of the 20th century, laparoscopic areas have gained remarkable achievements. The advantages of minimally invasive surgery—including less pain, quicker recovery, and shorter hospitalization time—have been realized in patients with intra-abdominal malignancies. However, more and more concerns about the safety of laparoscopy treatment have been aroused. A few clinical trials have reported that port site tumor metastases (PSM) and higher peritoneal tumor metastasis (PTM), rapidly growth rate of residual carcinoma in laparoscopic procedures than opening procedures. Compared with traditional operative procedures, the main pathologicphysiolic difference between the two methods is cause by pnemumoperitoneum with carbon dioxide (C02). On the other hand, most of the complications are related with improper manipulation. Furthermore, no consistent conclusion of the in vitro and in vivo experiments about C02 and the proliferation, adhesion and invasion of carcinoma has been drawn.
Therefore, this research is aimed to systematically observe the influences of different C02 pressure models to imitating realistic laparoscopic manipulation situation on the proliferate, adhesive and
第一部份不同CO2压力状态对卵巢癌SKOV3细胞体外增殖能力的影响
【目的】通过观察模拟腹腔镜实际操作时的不同C02压力、作用不同时间对卵巢癌SKOV3细胞体外生长、增殖能力的影响,评估C02人工气腹对恶性卵巢肿瘤细胞体外生长、增殖的直接作用并探讨相关机制。
In the last decade of the 20th century, laparoscopic areas have gained remarkable achievements. The advantages of minimally invasive surgery—including less pain, quicker recovery, and shorter hospitalization time—have been realized in patients with intra-abdominal malignancies. However, more and more concerns about the safety of laparoscopy treatment have been aroused. A few clinical trials have reported that port site tumor metastases (PSM) and higher peritoneal tumor metastasis (PTM), rapidly growth rate of residual carcinoma in laparoscopic procedures than opening procedures. Compared with traditional operative procedures, the main pathologicphysiolic difference between the two methods is cause by pnemumoperitoneum with carbon dioxide (C02). On the other hand, most of the complications are related with improper manipulation. Furthermore, no consistent conclusion of the in vitro and in vivo experiments about C02 and the proliferation, adhesion and invasion of carcinoma has been drawn.
Therefore, this research is aimed to systematically observe the influences of different C02 pressure models to imitating realistic laparoscopic manipulation situation on the proliferate, adhesive and
引文
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[3]. Kosugi C, Ono M, Saito N, et al. Port site recurrence diagnosed by positron emission tomograpHy after laparoscopic surgery for colon cancer. Hepatogastroenterology[J]. 2005;52(65):1440-3
[4]. Izumi K, Ishikawa K, Shiroshita H, et al. MorpHological changes in hepatic vascular endothelium after carbon dioxide pneumoperitoneum in a murine model.Surg Endosc[J]. 2005,19:554-558
[5]. Wittich P, Mearadji A, Marquet RL,et al.Increased tumor growth after high pressure pneumoperitoneum with helium and air[J]. J Laparoendosc Adv Surg Tech A,2004,14:205-208
[6]. Curet MJ. Port site metastases[J]. Am J Surg,2004,187:705-712
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[8]. The Clinical Outcomes of Surgical Therapy Study Group(2004).A comparison of laparoscopically assisted and open colectomy for colon cancer[J]. N Engl J Med,2004,350:2050–2059.
[9]. Lacy AM, Garcia-Valdecasas JC, Delgado S,et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial[J]. Lancet,2002,359:2296–2229.
[10]. Hirabayashi Y, Yamaguchi K, Shiraishi N, etal. Development of port site metastasis after pneumoperitoneum[J]. Surg Endosc,2002,16: 864-868.Schmeding M, Schwalbach P, Reinshagen S,etal. Helium pneumoperitoneum reduces tumor recurrence after curative laparoscopic liver resection in rats in a tumor-bearing small animal model[J]. Surg Endosc,2003,17:951-959
[12]. Schafer M, Krahenbuhl L. Effect of laparoscopy on intraabdominal blood flow[J]. Surgery,2001,129:385–389.
[13]. Schmandra TC, Kim ZG, Gutt CN. Effect of insulation gas and intraabdominal pressure on portal venous flow during pneumoperitoneum in the rat[J]. Surg Endosc,2001,15:405–408.
[14]. Ost MC, Tan BJ, Lee B, et al.Urological laparoscopy: basic pHysiological considerations and immunological consequences[J]. J Urol,2005,174:1183-1188.
[15]. 刘国礼. 现代微创外科学[M].北京,科学出版社,2003 年第 1 版,40-42.
[16]. 司徒镇强,吴军政. 细胞的生存环境. 细胞培养[M]. 西安,世界图书出版社, 第一版,2004 年,19.
[17]. 张爱容,孔北华. 纯二氧化碳气体环境对卵巢癌细胞株生长增殖的影响[A]中国优秀硕、博士学位论文.二氧化碳气腹环境对卵巢癌生长、转移影响的实验研究. 2004,12-26.
[18]. 徐春阳,粱志清,熊光武. 二氧化碳人工气腹对子宫内膜癌细胞体外生长的影响[J].中华妇产科杂志,2003,38:766-767.
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