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目的探讨手术治疗结直肠癌对CD133分子表达的影响与临床意义。方法将120例结直肠癌患者随机分为试验组60例与对照组60例。试验组予以腹腔镜下手术切除治疗,对照组予以传统开腹手术治疗。2组患者术后均给予静脉注射72~162 mg·m-2奥利沙铂,第1天+静脉滴注200 mg·m-2亚叶酸钙,第1天+静脉注射1.30 g·m-25-氟尿嘧啶,第1,2天。2组患者1个周期均为21 d,共治疗3个周期。比较2组患者的围手术指标、并发症、血清白细胞介素(IL)-6和IL-10含量变化与CD133分子表达量变化。结果试验组的术中出血量、术后留置尿管天数、肠蠕动恢复时间与术后住院时间均明显少于对照组(P<0.05)。试验组术后尿潴留、感染、肠梗阻与吻合口漏等总体并发症发生率明显均少于对照组(P<0.05)。术后,2组患者的血清IL-6和IL-10含量较治疗前均明显下降(P<0.05),且试验组术后的血清IL-6和IL-10含量明显少于对照组(P<0.05)。术后,2组患者的CD133分子表达量较治疗前明显升高(P<0.05),且试验组术后的CD133分子表达量明显高于对照组(P<0.05)。结论腹腔镜下手术治疗结直肠癌能促进患者的康复,并发症少,对患者的创伤与应激反应的作用少,其机制可能在于能够有效地提高CD133分子的表达。
Objective To investigate the effect of surgical treatment of colorectal cancer on the expression of CD133 and its clinical significance. Methods A total of 120 patients with colorectal cancer were randomly divided into experimental group (60 cases) and control group (60 cases). The experimental group was treated by laparoscopic surgery and the control group was treated by traditional laparotomy. Two groups of patients were given intravenous 72 ~ 162 mg · m-2 oliposa platinum, intravenous infusion of 200 mg · m-2 leucovorin on the first day + 1.30 g · m-25 on the first day - Fluorouracil, Day 1 and Day 2 One cycle of two groups of patients were 21 days, a total of three cycles. Perioperative parameters, complications, changes of serum IL-6 and IL-10 levels and CD133 expression in the two groups were compared. Results The intraoperative blood loss, days of postoperative indwelling catheter, recovery of bowel movement and postoperative hospital stay were significantly less than those of the control group (P <0.05). Postoperative urinary retention, infection, intestinal obstruction and anastomotic leakage were significantly less in the experimental group than in the control group (P <0.05). After operation, the levels of IL-6 and IL-10 in the two groups were significantly lower than those before treatment (P <0.05), and the levels of serum IL-6 and IL-10 in the experimental group were significantly lower than those in the control group <0.05). After operation, the expression of CD133 in two groups was significantly higher than that before treatment (P <0.05), and the expression of CD133 in the experimental group was significantly higher than that in the control group (P <0.05). Conclusions Laparoscopic surgery for colorectal cancer can promote the recovery of patients with fewer complications and less effect on the patients’ trauma and stress response. The possible mechanism is that it can effectively improve the expression of CD133.