| 赵树立 陈仕林 许林 张勤 冯纯伟 冯东杰 王中秋 胡江文 张治 邱宁雷 贾辉.胸腔镜术与右侧开胸术对中早期食管癌患者微转移相关因子水平影响的随机对照研究[J].,2015,15(26):5103-5106 |
| 胸腔镜术与右侧开胸术对中早期食管癌患者微转移相关因子水平影响的随机对照研究 |
| Micrometastases Related Factors of Patients Following Esophageal Surgeryfor Esophageal Cancers: a Comparative Study between Video-assistedThoracoscopic Surgery and Right Thoracotomy |
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| DOI： |
| 中文关键词: 电视胸腔镜手术 食管癌 细胞角蛋白 高迁移率族蛋白B1 白细胞介素1beta |
| 英文关键词: VATS Esophageal cancer CK19/20 HMGB1 IL1-beta |
| 基金项目:江苏省六大人才高峰项目(2011-WS-115) |
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| 中文摘要: |
| 目的：比较电视胸腔镜手术(VATS)与右侧开胸手术治疗中早期食管癌的临床疗效以及对患者血清微转移相关因子的影响。
方法：选取60 例食管癌患者作为研究对象，根据术式将其随机分为开胸对照组(30 例)和VATS 术组(30 例)，分析和比较两组患者
的手术时间、术中出血量、下床活动时间及术后并发症发生率，并分别检测和比较两组手术前后胸腔灌洗液脱落肿瘤细胞标志
CK19、CK20 的mRNA 水平以及血清中IL1-茁和HMGB1 的水平。结果：与开胸组相比，VTSA 组的手术出血量、术后出院时间均
明显少于或短于对照组(P<0.05)，且其术后24 h、72 h胸腔引流液及外周血术后3 d、7 d的IL-1茁水平均低于开胸组(P<0.05)，而仅
术后24 h的胸腔引流液HMGB1 水平低于开胸组(P<0.05)，两组其它时点HMGB1 水平比较均没有统计学差异(P>0.05)。两组术
后CK19、CK20 的mRNA水平比较没有统计学差异(P>0.05)。结论：与传统开胸手术相比，VATS 辅助下的食管癌根治术不仅具
有患者恢复快的特点，而且对于手术引起的转移相关因子较低，值得临床推广应用。 |
| 英文摘要: |
| Objective:To compare the clinical efficacy of video assisted thoracoscopic surgery (VATS) and the levels of micrometastases
related factors of esophageal-resection patients.Methods:A total of 60 pa- tients with early esophageal cancer who underwent
either a VATS (30) or a thoracotomy (30) were recruited for this study, whose clinical efficacies(operative time, bleeding, complications
and hospitalization time ) were analyzed. The blood and pleural fluid samples of the participants were taken preoperatively and at
post-operatively 24/72h (for pleural lavage) or 3/7 day (for blood) to analyze the CK19/20 mRNA levels in tumor shedding cells by
Q-PCR and the protein levels of IL1-beta and HMGB1 in blood or pleural fluid samples by ELISA.Results:Compared with the thoracotomy
group, patients in the VATSgroup lost significantly less blood, and got quicker recovery (P<0.05). Both IL1-beta and HMGB1 concentrations
in blood and chest drainage fluid of patients in VATS group were significantly lower than those in the thoracotomy control group (P<0.
05). No significant difference was found between two groups in the mRNA levels of CK19 and CK20 in chest drainage fluid samples
(P>0.05).Conclusion:Compared with the traditional thoracotomy approach, VATS tu- mor esophagectomy could promote the recovery,
and had fewer impact on the micrometastases related factors, which it was worthy of clinical popularization. |
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