文章摘要

腹腔镜结肠癌根治术治疗结肠癌的效果及对肿瘤转移风险、EGF水平的影响

作者: 1左 艳菊
1 河南省直第三人民医院肛肠科,郑州 450000
通讯: 左 艳菊 Email: sqszyj@yeah.net
DOI: 10.3978/j.issn.2095-6959.2019.09.019

摘要

目的:分析腹腔镜结肠癌根治术对结肠癌肿瘤转移风险、表皮生长因子(epidermal growth factor,EGF)水平影响及临床治疗效果。方法:回顾性选取2013年4月至2015年11月河南省直第三人民医院收治的112例结肠癌患者,根据手术方法不同分为两组,每组56例。开放组行开腹手术治疗,腔镜组行腹腔镜结肠癌根治术治疗,分析两组治疗后手术情况、并发症、肿瘤复发、转移情况及手术前后肿瘤转移潜能、EGF水平变化情况。结果:腔镜组手术时间长于开腹组(P<0.001),胃肠功能恢复时间短于开放组(P<0.001),术中出血量少于开放组(P<0.001),并发症率低于开放组(P=0.015),但局部复发率和远处转移与开放组比较差异无统计学意义(P=0.647,0.280)。术前两组TK1,EGF,SAA,IL-8,IL-17水平比较差异无统计学意义(均P>0.05)。术后腔镜组TK1,EGF,SAA,IL-8,IL-17水平低于开放组(均P<0.05)。术前,两组外周血GCC-mRNA表达阳性率水平比较差异无统计学意义(P=0.848)。术后,腔镜组外周血GCC-mRNA表达阳性率高于开放组,但组间比较差异无统计学意义(P=0.411)。结论:腹腔镜结肠癌根治术治疗结肠癌可减少术中出血,缩短术后康复时间,降低患者血清中TK1,EGF,SAA,IL-8的表达水平,且并发症少,安全性高,但肿瘤转移风险与开腹组相当。
关键词: 腹腔镜;结肠癌根治术;肿瘤转移;开腹手术

Effect of laparoscopic radical colonic cancer radical operation on risk of metastasis for colon cancer and EGF levels and clinical therapeutic effect analysis

Authors: 1ZUO Yanju
1 Department of Anorectal, Third People’s Hospital of Henan Province, Zhengzhou 450000, China

CorrespondingAuthor:ZUO Yanju Email: sqszyj@yeah.net

Abstract

Objective: To analyze the effect of laparoscopic radical resection on risk of metastatic for colon cancer and epidermal growth factor (EGF) level and clinical outcomes of colon cancer. Methods: From April 2013 to November 2015, 112 patients with colon cancer were retrospectively divided into two groups: a control group and an observation group, 56 cases in each group. Laparotomy was performed in the open group and laparoscopic radical resection of colon cancer was performed in the endoscopic group. The operation, complications, tumor recurrence, metastasis, metastatic potential and EGF level were analyzed in the two groups. Results: The operative time of the endoscopic group was longer than that of the open group (P<0.001), the recovery time of gastrointestinal function was shorter than that of the open group (P<0.001), the amount of intraoperative bleeding was less than that of the open group (P<0.001), and the complication rate was lower than that of the open group (P=0.015), but there was no significant difference in local recurrence rate and distant metastasis between the 2 groups (P=0.647, 0.280). There was no significant difference in TK1, EGF, SAA, IL-8, IL-17 levels between the two groups before operation (all P>0.05). After operation, the level of TK1, EGF, SAA, IL-8, IL-17 in the endoscopic group was lower than that in the open group (all P<0.05). There was no significant difference in the expression of GCC-mRNA between the two groups before operation (P=0.848). After operation, the positive rate of GCC-mRNA expression in peripheral blood of endoscopic group was higher than that of open group, but there was no statistical difference between the two groups (P=0.411). Conclusion: Laparoscopic radical resection of colon cancer can reduce bleeding in hands, shorten the recovery time after operation, and reduce the expression of TK1, EGF, SAA and IL-8 in serum of patients with colon cancer, with fewer complications and high safety, but the metastatic potential of tumors is similar to that of the open group.
Keywords: laparoscope; radical operation of colon cancer; tumor metastasis; open surgery