论文部分内容阅读
目的研究后腹腔镜手术对T1期局限性肾癌患者血液中细胞黏附分子表达的影响。方法将符合纳入标准的62例患者随机分为后腹腔镜组(n=31)与开放组(n=31),采用酶联免疫吸附法(ELISA)检测术前1d及术后第1d、第5d患者血清中可溶性分化抗原44拼接变异体6(sCD44v6)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)和可溶性上皮钙黏素(sE-cadherin)等细胞黏附分子的表达水平。结果术后第1d两组sCD44v6、sICAM-1、sVCAM-1均高于术前1d(P<0.05),其中后腹腔镜组sCD44v6高于开放组(P<0.05);两组sE-cadherin均低于术前1d,但差异无统计学意义(P>0.05),两组间比较差异亦无统计学意义(P>0.05)。术后第5d两组所有指标与术前1d相比,差异均无统计学意义(P>0.05);两组间各项指标分别比较,差异亦无统计学意义(P>0.05)。62例肾癌患者分别随访4～14个月,无1例出现肿瘤局部复发、穿刺孔转移、切口转移或远处转移。两组肿瘤特异生存率均为100%。结论后腹腔镜肾癌根治术术后早期细胞黏附分子的表达出现变化,但持续时间短,与开放手术比较无明显差异。两种术式术后中短期内患者肿瘤相关随访结果相似,后腹腔镜肾癌根治术不增加中短期内肾癌细胞转移。
Objective To study the effect of retroperitoneal laparoscopic surgery on the expression of cell adhesion molecules in the blood of patients with T1-stage renal cell carcinoma. Methods Sixty-two patients who met the inclusion criteria were randomly divided into retroperitoneal laparoscopic group (n = 31) and open group (n = 31) Serum levels of sCD44v6, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble epithelial cadherin (sE- cadherin) and other cell adhesion molecules expression levels. Results The sCD44v6, sICAM-1 and sVCAM-1 in the first postoperative day were significantly higher than those in the preoperation 1 day (P <0.05), while sCD44v6 in the laparoscopic group was higher than that in the open group (P <0.05) (P> 0.05), but there was no significant difference between the two groups (P> 0.05). There was no significant difference between the two groups on the 5th day after operation (P> 0.05). There was no significant difference between the two groups (P> 0.05). 62 patients with renal cell carcinoma were followed up for 4 to 14 months, no tumor recurrence occurred in 1 case, puncture hole transfer, incision transfer or distant metastasis. Tumor-specific survival rates were 100% for both groups. Conclusion The expression of cell adhesion molecules changes in the early postoperative laparoscopic radical nephrectomy, but the duration is short, which is not significantly different from the open operation. Two kinds of surgical short-term postoperative follow-up of patients with similar tumor-related, retroperitoneal laparoscopic radical nephrectomy does not increase renal cell metastasis in the short term.