完全胸腔镜与开放性肺叶切除术治疗的非小细胞肺癌患者围手术期IGFBP-3、VEGF、IL-6水平的比较

被引:7
作者
蒲振业 [1 ]
陈亮 [1 ]
朱全 [1 ]
潘世扬 [2 ]
秦雪君 [2 ]
机构
[1] 南京医科大学第一附属医院胸心外科
[2] 南京医科大学第一附属医院医学检验科
关键词
肺叶切除术; 电视胸腔镜; 免疫抑制; IL-6; IGFBP-3; VEGF;
D O I
暂无
中图分类号
R734.2 [肺肿瘤];
学科分类号
摘要
目的:通过测定因非小细胞肺癌(NSCLC)行完全胸腔镜肺叶切除术或开放肺叶切除术的患者血清中白细胞介素-6(IL-6)、胰岛素样生长因子结合蛋白-3(IGFBP-3)、血管内皮生长因子(VEGF)的含量,比较两种手术方式对NSCLC患者术后免疫功能及预后的影响。方法:选取NSCLC患者40例,分别行完全胸腔镜肺叶切除术(tVATS组)及传统开放肺叶切除术(TOS组),每组20例。采用酶联免疫吸附法测定两组患者术前、术后第1、3、5天外周血中IL-6、IGFBP-3、VEGF的含量,同时收集其他临床资料,并进行比较。结果:行胸腔镜肺叶切除术的患者与行传统开放肺叶切除术的患者相比,术前血清中的IL-6、IGFBP-3、VEGF的含量无统计学差异(P=0.328,0.788,0.458);术后第1、3、5天的IL-6及VEGF水平tVATS组均低于TOS组;IGFBP-3水平术后3个时间点tVATS组均高于TOS组。两组无死亡病例,均未出现术后并发症,tVATS组无中转开胸。两组的手术时间、清扫淋巴结站数及个数、术后引流时间、引流量无显著性差异(P>0.05)。tVATS组的术中失血量、术后疼痛评分、术后下床活动日、术后住院天数明显低于TOS组,有显著性差异(P<0.05)。结论:胸腔镜肺叶切除较开放肺叶切除术对患者手术创伤小、免疫功能影响轻,对于术后肿瘤转移、复发的影响较小,可以改善患者的预后,为后续治疗提供有利条件。
引用
收藏
页码:1027 / 1031
页数:5
相关论文
共 10 条
[1]  
Thoracoscopic lobectomy: Report on safety, discharge independence, pain, and chemotherapy tolerance[J] . Daniel G. Nicastri,Juan P. Wisnivesky,Virginia R. Litle,Jaime Yun,Cynthia Chin,Francine R. Dembitzer,Scott J. Swanson.The Journal of Thoracic and Cardiovascular Surgery . 2008 (3)
[2]   Persistent elevation of plasma vascular endothelial growth factor levels during the first month after minimally invasive colorectal resection [J].
Belizon, A. ;
Balik, E. ;
Horst, P. ;
Feingold, D. ;
Arnell, T. ;
Azarani, T. ;
Cekic, V. ;
Skitt, R. ;
Kumara, S. ;
Whelan, R. L. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2008, 22 (02) :287-297
[3]  
Major Abdominal Surgery Increases Plasma Levels of Vascular Endothelial Growth Factor: Open More So Than Minimally Invasive Methods[J] . Avraham Belizon,Emre Balik,Daniel L. Feingold,Marc Bessler,Tracey D. Arnell,Kenneth A. Forde,Patrick K. Horst,Suvinit Jain,Vesna Cekic,Irena Kirman,Richard L. Whelan.Annals of Surgery . 2006 (5)
[4]   Thoracotomy is associated with significantly more profound suppression in lymphocytes and natural killer cells than video-assisted thoracic surgery following major lung resections for cancer [J].
Ng, CSH ;
Lee, TW ;
Wan, S ;
Wan, IYP ;
Sihoe, ADL ;
Arifi, AA ;
Yim, APC .
JOURNAL OF INVESTIGATIVE SURGERY, 2005, 18 (02) :81-88
[5]   Is minimal access surgery for cancer associated with immunologic benefits? [J].
Ng, CSH ;
Whelan, RL ;
Lacy, AM ;
Yim, APC .
WORLD JOURNAL OF SURGERY, 2005, 29 (08) :975-981
[6]  
Insulin-like growth factor (IGF)-I, IGF binding protein-3, and cancer risk: systematic review and meta-regression analysis[J] . Andrew G Renehan,Marcel Zwahlen,Christoph Minder,Sarah T O’Dwyer,Stephen M Shalet,Matthias Egger.The Lancet . 2004 (9418)
[7]   Suppression of cellular immunity by surgical stress [J].
Ogawa, K ;
Hirai, M ;
Katsube, T ;
Murayama, H ;
Hamaguchi, K ;
Shimakawa, T ;
Naritake, Y ;
Hosokawa, T ;
Kajiwara, T .
SURGERY, 2000, 127 (03) :329-336
[8]   Better pulmonary function and prognosis with video-assisted thoracic surgery than with thoracotomy [J].
Kaseda, S ;
Aoki, T ;
Hangai, N ;
Shimizu, K .
ANNALS OF THORACIC SURGERY, 2000, 70 (05) :1644-1646
[9]   Changes in immune function following surgery for esophageal carcinoma [J].
Tashiro, T ;
Yamamori, H ;
Takagi, K ;
Hayashi, N ;
Furukawa, K ;
Nitta, H ;
Toyoda, Y ;
Sano, W ;
Itabashi, T ;
Nishiya, K ;
Hirano, J ;
Nakajima, N .
NUTRITION, 1999, 15 (10) :760-766
[10]   Circulating concentrations of insulin-like growth factor-I and risk of breast cancer [J].
Hankinson, SE ;
Willett, WC ;
Colditz, GA ;
Hunter, DJ ;
Michaud, DS ;
Deroo, B ;
Rosner, B ;
Speizer, FE ;
Pollak, M .
LANCET, 1998, 351 (9113) :1393-1396