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目的检测结肠癌根治性切除术前后胰岛素抵抗指数以及NF-κB、IL-6、TNF-α的表达情况,初步探讨NF-κB细胞因子在结肠癌术后胰岛素抵抗的作用机制。方法比较67例结肠癌根治性切除术患者手术前后胰岛素抵抗指数的变化,根据胰岛素抵抗指数增加值将手术患者分为低胰岛素抵抗组和高胰岛素抵抗组。分析各组术后NF-κB、IL-6和TNF-α的表达。结果术后血糖、胰岛素浓度及IR指数较术前明显升高,差异有统计学意义(P<0.01)。低IR组和高IR组术后IR指数较术前均显著升高,差异有统计学意义(P<0.01)。高IR组术后NF-κB、IL-6、TNF-α表达水平均高于低IR组,差异均有统计学意义(P<0.01)。术后NF-κB表达量与术后IR指数增加值呈正相关(r=0.596,P<0.01)。结论 NF-κB可能通过调节IL-6、TNF-α等炎症因子,进而影响在结肠癌术后胰岛素抵抗作用。
Objective To detect the insulin resistance index and the expression of NF-κB, IL-6 and TNF-α before and after radical resection of colon cancer and to explore the mechanism of the effect of NF-κB cytokine on postoperative insulin resistance in colon cancer. Methods The changes of insulin resistance index in 67 patients with radical resection of colon cancer before and after operation were compared. According to the increase of insulin resistance index, the patients were divided into low insulin resistance group and high insulin resistance group. The expressions of NF-κB, IL-6 and TNF-α in each group were analyzed. Results Postoperative blood glucose, insulin concentration and IR index were significantly higher than those before operation, the difference was statistically significant (P <0.01). The IR index of low IR group and high IR group was significantly higher than that before operation (P <0.01). The levels of NF-κB, IL-6 and TNF-α in high IR group were significantly higher than those in low IR group, the difference was statistically significant (P <0.01). The postoperative expression of NF-κB was positively correlated with the postoperative increase of IR index (r = 0.596, P <0.01). Conclusion NF-κB may affect the postoperative insulin resistance of colon cancer by regulating the inflammatory factors such as IL-6 and TNF-α.