论文部分内容阅读
目的:探讨直肠系膜切除术对直肠癌根治术后局部复发患者血清基质金属蛋白酶、肿瘤标志物(CEA、CA199)及生存率的影响。方法:收集直肠原发癌位于直肠中下段的病例,行直肠癌根治术复发再入院患者48例(均为本院2010年4月-2014年3月手术后的病例),按照手术方式的不同分为2组,分别24例。对照组采用姑息性手术治疗,研究组采用直肠系膜切除术治疗,采用ELISA法测定血清MMP-2、MMP-9、CEA、CA199水平,记录所有患者术后并发症状况,术后进行随访时间为3年,比较两组1年、3年的生存率状况。结果:对照组在手术时间、出血量、住院时间上高于研究组,(P<0.05);对照组在肛门排气时间上低于研究组,(P<0.05);与治疗前比较,两组患者治疗2周后MMP-2、MMP-9表达水平降低,治疗2周后血清CEA、CA199表达水平降低(P<0.05);与对照组比较,研究组患者治疗2周后MMP-2、MMP-9表达水平较低,治疗2周后血清CEA、CA199表达水平较低(P<0.05);两组患者治疗期间并发症无差异(P>0.05);两组间术后1年生存率,无差异(P>0.05);研究组术后3年生存率(66.67%)高于对照组(37.50%),(P<0.05)。结论:直肠系膜切除术可提高直肠癌根治术后局部复发患者的长期生存率,降低血清MMP-2、MMP-9、CEA、CA199水平,安全性高,值得广泛推广。
Objective: To investigate the effect of mesorectal excision on serum matrix metalloproteinase (CEA), tumor markers (CEA, CA199) and survival rate in patients with local recurrence after radical resection of rectal cancer. Methods: The cases of primary rectal cancer located in the middle and lower rectum of rectum were collected. Forty-eight patients with recurrent re-admission of rectal cancer underwent radical resection (all from April 2010 to March 2014 in our hospital). According to the operation method Divided into two groups, respectively, 24 cases. The control group was treated with palliative surgery. The study group was treated by mesorectal excision. The serum levels of MMP-2, MMP-9, CEA and CA199 were measured by ELISA. The postoperative complications were recorded. The follow-up time was 3 years, compared two groups of 1 year, 3 year survival rate. Results: The operation time, bleeding volume and length of hospital stay in the control group were significantly higher than those in the study group (P <0.05). The control group was shorter than the study group in the anal exhaust time (P <0.05) The expression of MMP-2 and MMP-9 decreased after 2 weeks in treatment group, but decreased in CEA and CA199 after 2 weeks of treatment (P <0.05). Compared with control group, MMP-2 and MMP- The expression of CEA and CA199 in serum was lower after 2 weeks of treatment (P <0.05). There was no difference in the complication between the two groups (P> 0.05). The 1-year survival rate (P> 0.05). The 3-year survival rate (66.67%) in the study group was significantly higher than that in the control group (37.50%) (P <0.05). Conclusion: Mesenteric resection can improve the long-term survival rate and reduce the levels of serum MMP-2, MMP-9, CEA and CA199 in patients with local recurrence after radical resection of rectal cancer, which is safe and worthy of widespread application.