摘要
目的 探讨腹腔镜与开腹胃癌D2根治术对患者IL-6和IL-10表达的影响及意义。方法 前瞻性分析2010年11月至2011年10月第三军医大学西南医院收治的146例胃癌患者的临床资料，采用密闭信封法将患者随机分为腹腔镜组（75例）及开腹组（71例）。按照第14版日本胃癌处理规约要求行胃癌D2根治术，术前及术后分别采集腹腔冲洗液。采用酶联免疫吸附法测量腹腔冲洗液中IL-6、IL-10浓度。计量资料采用t检验，计数资料采用X2检验。结果 腹腔镜组和开腹组患者术前腹腔冲洗液中IL-6的浓度分别为（34±13）μg/L和（35±12）μg /L，两者比较，差异无统计学意义（t=-5.110，P〉0.05）；两组术后腹腔冲洗液中IL-6浓度分别为（4015±1592）μg /L和（6724±2112）μg /L，腹腔镜组术后腹腔冲洗液中IL-6〖JP〗的浓度显著低于开腹组（t=8.367，P〈0.05），且同种手术方式术后腹腔冲洗液中IL-6的浓度均较术前显著增高（t=-59.065，-87.123，P〈0.05）。腹腔镜组和开腹组患者术前腹腔冲洗液中IL-10的浓度分别为（43±9）μg /L和（42±10）μg /L，两者比较，差异无统计学意义（t=1.190，P〉0.05）；两组术后腹腔冲洗液中IL-10的浓度分别为（92±32）μg /L和（62±23）μg /L，腹腔镜组术后腹腔冲洗液中IL-10的浓度显著高于开腹组（t=6.408， P〈0.05），且同种手术方式术后腹腔冲洗液中IL-10的浓度均较术前显著增高（t=-12.680，-6.802，P〈0.05）。结论 腹腔镜胃癌D2根治术后患者腹腔局部炎症反应较开腹胃癌D2根治术轻，对于防止IL-6介导的胃癌腹腔转移可能有一定作用。
Objective To compare the effects and significance of laparoscopic and open D2 gastrectomy on the expression of interleukin （IL）-6 and IL-10.Methods The clinical data of 146 patients with gastric cancer who were admitted to the Southwest Hospital from November 2010 to October 2011 were prospectively analyzed. All the patients were randomly divided into the laparoscopic group （75 patients） and open group （71 patients） according to the sealed envelope method. Laparoscopic or open D2 gastrectomy were performed according to the 14th edition of gastric cancer treatment guidelines of Japan Gastric Cancer Association. Peritoneal lavage fluid was collected at the beginning and the end of operation, and the concentrations of IL-6 and IL-10 in the peritoneal lavage fluid were detected by enzyme linked immunosorbent assay. The measurement data were analyzed using the t test, and the count data were analyzed using the chi square test.Results The preoperative concentrations of IL-6 in the laparoscopic group and the open group were （34±13）μg/L and （35±12）μg/L, respectively, with nosignificantdifference between the 2 groups （t=-5.110, P〖WTBZ〗〉0.05）. The postoperative concentrations of IL-6 in the laparoscopic group and the open group were （4015±1592）μg/L and （6724±2112）μg/L, respectively. The postoperative concentration of IL-6 in the laparoscopic group was significantly lower than that of the open group （t=-8.367, P〈0.05）, and the postoperative concentrations of IL-6 were significantly higher than those before operation in the laparoscopic group and open group （t=-59.065,-87.123, P〈0.05）. The preoperative concentrations of IL-10 in the laparoscopic group and the open group were （43±9）μg/L and （42±10）μg/L, respectively, with no significant difference between the 2 groups（t=1.190, P〉0.05）.The postoperative concentrations of IL-10 in the laparoscopic group and the open group were （92±32）μg/L and （62±23） μg /L, respectively. The postoperative concentration of IL-10 was significantly higher than that of the open group （t=6.408, P〈0.05）, and the postoperative concentrations of IL-10 were significantly higher than those before operation in the laparoscopic group and the open group （t=-12.680,-6.802, P〈0.05）.Conclusion Peritoneal inflammatory reaction is relatively lighter after laparoscopic D2 gastrectomy when compared with open D2 gastrectomy, which might prevent the peritoneal metastasis of gastric cancer mediated by IL-6.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2013年第5期358-361,共4页
Chinese Journal of Digestive Surgery
基金
重庆市科技攻关课题（CSTC2009AB5035）
