摘要
目的观察腹腔镜下"淋巴引流区"前哨淋巴结清扫直肠癌根治术对患者的疗效及环氧化酶-2(COX-2)、前列腺素E2(PGE2)、β-连环蛋白(β-catenin)信号通路的影响。方法选取93例直肠癌患者,按照不同治疗方法分为观察组和对照组。对照组给予常规直肠癌根治术,观察组在对照组的基础上使用示踪剂对"淋巴引流区"前哨淋巴结清扫。观察两组患者的手术时间、术中出血量、淋巴结数量、术后排气时间、住院时间,以及治疗前后的COX-2、PGE2、β-catenin表达量变化。结果观察组患者的手术时间和术后肛门排气时间短于对照组,术中出血量少于对照组,淋巴结清扫数量多于对照组,差异均有统计学意义(Z=-7.19,t=-2.12,Z分别=-2.17、6.85,P均<0.05);两组患者的吻合口并发症、其他并发症及住院时间比较,差异均无统计学意义(χ~2分别=0.53、1.58,t=1.58,P均>0.05)。观察组治疗后的COX-2、PGE2和β-catenin表达量均低于对照组,差异均有统计学意义(t分别=3.92、2.27、5.73,P均<0.05)。结论腹腔镜下"淋巴引流区"前哨淋巴结清扫直肠癌根治术临床有效,并能够减少COX-2、PGE2、β-catenin的表达量。
Objective To observe the effect of"lymphatic drainage area"sentinel lymph node dissection under the laparoscopy on COX-2,PGE2,andβ-catenin signaling pathways of patients with rectal cancer.Methods A total of 93 patients with rectal cancer were divided into the the observation group and the control group according to different treatment methods.The control group received conventional radical resection of rectal cancer,and the observation group received sentinel lymph node dissection in the"lymphatic drainage area"with tracer on the basis of the control group.The changes of the operation time,intraoperative blood loss,number of lymph nodes,postoperative exhaust time,hospitalization time,and COX-2,PGE2,β-catenin expressions in the two groups before and after the treatment were observed.Results The operation time and the postoperative exhaust time of the observation group were shorter than those of the control group,the intraoperative bleeding volume in the observation group was less than that in the control group,and the number of lymph node dissection in the observation group was more than that in the control group(Z=-7.19,t=-2.12,Z=-2.17,6.85,P<0.05).There was no statistically significant difference in anastomotic complications,other complications,and hospitalization time between the two groups(χ2=0.53,1.58,t=1.58,P>0.05).After the treatment,the expressions of COX-2,PGE2,andβ-catenin in the observation group were lower than those in the control group(t=3.92,2.27,5.73,P>0.05).Conclusion Laparoscopic"lymphatic drainage"sentinel lymph node dissection for rectal cancer is effective and can reduce the expressions of COX-2,PGE2 andβ-catenin.
作者
张磊
邵峰
李丽军
ZHANG Lei;SHAO Feng;LI Lijun(Department of Anorectal Surgery,Dongyang People's Hospital,Dongyang 322100,China)
出处
《全科医学临床与教育》
2021年第2期117-120,共4页
Clinical Education of General Practice
