文章摘要

腹腔镜手术与传统手术治疗低位直肠癌的效果及对细胞免疫和NKG2D、SOD水平的影响

作者: 1张焱辉, 1李靖锋, 1朱志贤
1 靖江市中医院普外科，江苏 靖江 214500
通讯: 张焱辉 Email: zyhcck2003@163.com
DOI: 10.3978/j.issn.2095-6959.2022.10.023
基金: 泰州市科技支撑计划(社会发展)项目(0612ws2017641)。

摘要

目的：分析腹腔镜手术与传统手术治疗低位直肠癌的疗效及对免疫功能和自然杀伤细胞2D(natural killer cell group 2D，NKG2D)、超氧化物歧化酶(superoxide dismutase，SOD)水平的影响。方法：选择靖江市中医院2018年1月至2021年5月收治的120例低位直肠癌患者，依照治疗方案不同分为观察组与对照组。观察组患者采用腹腔镜直肠癌根治术方案进行治疗，对照组给予开腹直肠癌根治术治疗。记录2组术后肛门排气时间、术中出血量、进食时间、总住院时间等治疗一般情况。术前及术后1周时采集受试者空腹静脉血离心收集血清检测患者血清中白细胞介素-6(interleukin 6，IL-6)、IL-10、免疫球蛋白A(immunoglobulin A，IgA)、IgG、IgM、NKG2D、SOD水平。采用流式细胞术法检测患者血中分化簇3(CD3+)、分化簇4(CD4+)、分化簇8(CD8+)、自然杀伤(natural killer，NK)细胞、自然杀伤T(natural killer T，NKT)细胞水平，计算CD4+/CD8+值。结果：观察组患者治疗后肛门排气时间、术中出血量、总住院时间及进食时间均明显低于对照组，且差异有统计学意义(均P<0.05)。治疗后观察组患者血中IL-6水平明显低于对照组，IL-10水平明显高于对照组，且差异有统计学意义(P<0.05)。治疗后观察组患者血中IgA、IgG及IgM水平均明显高于对照组，且差异有统计学意义(均P<0.05)。治疗后观察组患者血中CD3+、CD4+、NK、CD4+/CD8+水平均明显高于对照组，CD8+明显低于对照组，且差异有统计学意义(均P<0.05)。治疗后观察组患者血中NKG2D、SOD水平明显低于对照组，且差异有统计学意义(P<0.05)。结论：相较于传统手术治疗方案，采用腹腔镜手术对低位直肠癌患者治疗后可有效提高患者治疗临床疗效，改善患者免疫功能，并降低NKG2D、SOD水平。
关键词： 腹腔镜手术；传统手术；低位直肠癌；免疫功能；自然杀伤细胞2D；超氧化物歧化酶

Laparoscopic surgery and traditional surgery in the treatment of low rectal cancer and its effect on cellular immune function and NKG2D and SOD levels

Authors: 1ZHANG Yanhui, 1LI Jingfeng, 1ZHU Zhixian
1 Department of General Surgery, Jingjiang Hospital of Traditional Chinese Medicine, Jingjiang Jiangsu 214500, China

CorrespondingAuthor: ZHANG Yanhui Email: zyhcck2003@163.com

DOI: 10.3978/j.issn.2095-6959.2022.10.023

Foundation: This work was supported by the Taizhou Science and Technology Support Program (Social Development) Project, China (0612ws2017641).

Abstract

Objective: To analyze the curative effect of laparoscopic surgery and traditional surgery in the treatment of low rectal cancer and its effects on immune function and natural killer cell group 2D (NKG2D) and superoxide dismutase (SOD) levels. Methods: A total of 120 patients with low rectal cancer treated in our hospital from January 2018 to May 2021 were divided into an observation group and a control group according to different treatment schemes. The observation group was treated with laparoscopic radical resection of rectal cancer, and the control group was treated with open radical resection of rectal cancer. The anal exhaust time, intraoperative bleeding, eating time, and total hospital stay were recorded. The fasting venous blood of the subjects was collected before the operation and 1 week after the operation. The serum was collected by centrifugation to detect the levels of interleukin 6 (IL-6), IL-10, immunoglobulin A (IgA), IgG, IgM, NKG2D, and SOD. The levels of CD3+, CD4+, CD8+, NK, and NKT in blood were detected by flow cytometry, and the value of CD4+/CD8+ was calculated. Results: The anal exhaust time, intraoperative bleeding, total hospital stay, and eating time in the observation group were significantly lower than those in the control group (all P<0.05). After the treatment, the level of IL-6 in the observation group was significantly lower than that in the control group, and the level of IL-10 was significantly higher than that in the control group (P<0.05). After the treatment, the levels of IgA, IgG, and IgM in the observation group were significantly higher than those in the control group (all P<0.05). After the treatment, the levels of CD3+, CD4+, NK, and CD4+/CD8+ in the observation group were significantly higher than those in the control group, and CD8+ was significantly lower than that in the control group (all P<0.05). After the treatment, the levels of NKG2D and SOD in the observation group were significantly lower than those in the control group (P<0.05). Conclusion: Compared with traditional surgical treatment, laparoscopic surgery can effectively improve the clinical efficacy, improve the immune function, and reduce the levels of NKG2D and SOD in patients with low rectal cancer.

Keywords： laparoscopic surgery; traditional surgery; low rectal cancer; immunity; natural killer cell group 2D; superoxide dismutase

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