摘要
目的探讨胸腔镜根治术治疗食管癌的近期疗效及对髓系细胞触发受体-1(TREM-1)、肿瘤坏死因子受体相关蛋白1(TRAP1)表达的影响。方法选取2016年6月至2019年6月山东省宁阳县第一人民医院诊治的68例食管癌患者,按分层抽样法分为胸腔镜根治术组和传统手术组,各34例。胸腔镜根治术组采用胸腔镜根治术进行治疗,传统手术组采用传统的颈、胸、腹三切口开放食管癌根治术进行治疗。比较两组患者术后炎性因子水平、免疫功能、肺功能及TREM-1、TRAP1表达的差异,以及并发症发生情况。结果两组患者术前肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-10水平比较差异无统计学意义(P>0.05);术后第2天两组患者TNF-α、IL-6、IL-10水平均高于手术前,且胸腔镜根治术组TNF-α、IL-6、IL-10水平低于传统手术组[(23.21±0.32)mg/L比(29.69±0.48)mg/L、(232.15±23.64)ng/L比(246.73±25.89)ng/L、(0.64±0.19)ng/L比(0.89±0.21)ng/L],差异有统计学意义(P<0.05)。术前两组患者免疫功能指标比较差异无统计学意义(P>0.05);术后第2天两组患者CD3^(+)、CD4^(+)、CD8^(+)水平均低于术前,CD4^(+)/CD8^(+)水平高于术前,且胸腔镜根治术组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平均高于传统手术组[(46.78±1a2.43)%比(41.32±9.36)%、(46.12±9.68)%比(41.59±7.98)%、(27.42±4.27)%比(21.38±3.16)%、1.47±0.46比1.25±0.27],差异有统计学意义(P<0.05)。术前两组患者第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC比较差异无统计学意义(P>0.05);术后第2天两组患者FEV1、FVC、FEV1/FVC均低于术前,且胸腔镜根治术组FEV1、FVC、FEV1/FVC均优于传统手术组[(2.37±0.72)L比(1.82±0.53)L、(3.34±1.06)L比(2.43±0.82)L、(62.47±15.26)%比(53.67±12.28)%],差异有统计学意义(P<0.05)。术前两组TREM-1、TRAP1表达水平比较差异无统计学意义(P>0.05),术后第2天胸腔镜根治术组TREM-1表达高于传统手术组(141.56±34.69比121.54±22.75),TRAP1表达低于传统手术组(1.63±0.51比2.11±0.64),差异有统计学意义(P<0.05)。胸腔镜根治术组术后并发症发生率低于传统手术组[5.88%(2/34)比23.53%(8/34)],差异有统计学意义(χ^(2)=4.221,P=0.040)。结论胸腔镜根治术治疗食管癌近期疗效优于传统手术组,可升高TREM-1表达,降低TRAP1表达,减轻机体炎性反应以及减少对机体免疫功能的影响。
Objective To investigate the short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer and its influence on the expression of trigger receptor-1(TRE-1)and tumor necrosis factor receptor-associated protein 1(TRAP1).Methods A total of 68 patients with esophageal cancer who were admitted to First People′s Hospital of Ningyang from June 2016 to June 2019 were selected and divided into thoracoscope radical surgery group and raditional surgery group by stratified sampling method,with 34 cases in each group.The thoracoscopic radical surgery group was treated with thoracoscopic radical surgery,and the traditional surgery group was treated with traditional open radical esophageal cancer surgery with neck,chest,and abdominal incisions.The levels of inflammatory factors,immune function,lung function indexes,TREM-1,TRAP1 expression and complications of the two groups were observed and compared.Results Before operation,the levels of inflammatory factors tumor necrosis factor(TNF)-α,interleukin(IL)-6,IL-10 in two groups had no significant differences(P>0.05).At 2 d after operation,the levels of TNF-α,IL-6,IL-10 in two groups were increased and the levels of above index in the thoracoscopic radical surgery group were lower than those in the traditional surgery group:(23.21±0.32)mg/L vs.(29.69±0.48)mg/L,(232.15±23.64)ng/L vs.(246.73±25.89)ng/L,(0.64±0.19)ng/L vs.(0.89±0.21)ng/L,and there were statistical differences(P<0.05).Before operation,the levels of CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in two groups had no significant differences(P>0.05).At 2 d after operation,the levels of CD3^(+),CD4^(+),CD8^(+)decreased and the level of CD4^(+)/CD8^(+)increased,and the levels of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)in the thoracoscopic radical surgery group were higher than those in the traditional surgery group:(46.78±1a2.43)%vs.(41.32±9.36)%,(46.12±9.68)%vs.(41.59±7.98)%,(27.42±4.27)%vs.(21.38±3.16)%,1.47±0.46 vs.1.25±0.27,and there were statistical differences(P<0.05).Before operation,the levels of forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC in two groups had no significant differences(P>0.05).At 2 day after operation,the levels of FEV1,FVC,FEV1/FVC in two groups decreased,and the levels of FEV1,FVC,FEV1/FVC in the thoracoscopic radical surgery group were higher than those in the traditional surgery group:(2.37±0.72)L vs.(1.82±0.53)L,(3.34±1.06)L vs.(2.43±0.82)L,(62.47±15.26)%vs.(53.67±12.28)%,and there were statistical differences(P<0.05).Before operation,the expression of TREM-1 and TRAP1 in two groups had no significant differences(P>0.05).At 2 d after operation,the expression of TREM-1in the thoracoscopic radical surgery group was higher than that of traditional surgery group:(141.56±34.69 vs.121.54±22.75);the expression of TRAP1 was lower than that of the traditional surgery group:(1.63±0.51 vs.2.11±0.64),and there were statistical differences(P<0.05).The postoperative complication rate of the thoracoscopic radical surgery group was lower than that of the traditional surgery group:5.88%(2/34)vs.23.53%(8/34),and there was statistical difference(χ^(2)=4.221,P=0.040).Conclusions The short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer is better than that of the traditional surgery group,which can increase the expression of TREM-1,reduce the expression of TRAP1,and reduce the inflammatory response and the impact on the immune function.
作者
王海峰
强光亮
谢博恒
杨东斌
杜焕旺
Wang Haifeng;Qiang Guangliang;Xie Boheng;Yang Dongbin;Du Huanwang(Department of Thoracic Surgery,First People′s Hospital of Ningyang,Shandong Ningyang 271400,China;Department of Thoracic Surgery,China-Japan Friendship Hospital,Beijing 100029,China;Department of Pathology,First People′s Hospital of Ningyang,Shandong Ningyang 271400,China;Department of Medical Imaging,First People′s Hospital of Ningyang,Shandong Ningyang 271400,China)
出处
《中国医师进修杂志》
2021年第4期322-327,共6页
Chinese Journal of Postgraduates of Medicine
关键词
食管肿瘤
胸腔镜
髓系细胞触发受体-1
肿瘤坏死因子受体相关蛋白1
疗效比较研究
Esophageal neoplasms
Thoracoscopes
Tissue myeloid cell trigger receptor-1
Tumor necrosis factor receptor-related protein 1
Comparative effectiveness research
