腹腔镜全结肠系膜切除术对右半结肠癌患者肿瘤标志物及外周血T细胞含量的影响

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摘要目的探讨腹腔镜全结肠系膜切除术（CME）对右半结肠癌患者肿瘤标志物及外周血T 细胞含量的影响。方法选取2019年1月至2021年2月就诊于江西省九江市第一人民医院的80 例右半结肠癌患者，按随机数字表法分为试验组和参考组，每组各40 例。参考组行开腹CME 治疗，试验组行腹腔镜下CME 治疗。比较两组的血清肿瘤标志物、外周血T 细胞亚群及并发症情况。结果两组术前的可溶性细胞黏附分子-1（SICAM-1）、结肠癌特异性抗原2（CCSA-2）、血管内皮生长因子（VEGF）水平比较，差异无统计学意义（P＞0.05）；两组术后的SICAM-1、CCSA-2、VEGF 水平均高于术前，差异有统计学意义（P＜0.05）；试验组术后的SICAM-1、CCSA-2、VEGF 水平低于参考组，差异有统计学意义（P＜0.05）。两组术后的CD4+、CD3+、CD8+水平低于术前，参考组的CD4+/CD8+水平低于术前，差异有统计学意义（P＜0.05）；试验组术后的CD4+/CD8+水平与术前比较，差异无统计学意义（P＞0.05）；试验组术后的CD4+、CD3+、CD4+/CD8+水平高于参考组，CD8+水平低于参考组，差异有统计学意义（P＜0.05）；试验组术后的并发症总发生率低于参考组，差异有统计学意义（P＜0.05）。结论右半结肠癌患者行腹腔镜下CME 治疗的安全性更高，可降低肿瘤标志物水平，对免疫功能影响较小，利于术后康复。

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	张学圆

关键词 ：右半结肠癌, 全结肠系膜切除术, 腹腔镜, 肿瘤标志物, T 细胞亚群

Abstract：Objective To investigate the influence of laparoscopic complete mesocolic excision (CME) on tumor markers and peripheral blood T cell content in patients with right colon cancer. Methods A total of 80 patients with right colon cancer who were admitted to the First People′s Hospital of Jiujiang City in Jiangxi Province from January 2019 to February 2021 were selected and divided into the experimental group and the reference group according to random number table method, with 40 patients in each group. The reference group received open CME treatment, and the experimental group received laparoscopic CME treatment. The level of serum tumor markers, peripheral blood T cell subsets and complications were compared between the two groups. Results There was no significant difference in the level of soluble intercellular adhesion molecule-1 (SICAM-1), colon cancer specific antigen 2 (CCSA-2) and vascular endothelial growth factor (VEGF) between the two groups before surgery (P＞0.05). The levels of SICAM-1, CCSA-2 and VEGF in the two groups after surgery were higher than those before surgery, and the differences were statistically significant (P＜0.05). The levels of SICAM-1, CCSA-2 and VEGF in the experimental group were lower than those in the reference group, and the differences were statistically significant (P＜0.05). The levels of CD4+, CD3+ and CD8+ in the two groups after surgery were lower than those before surgery, and the level of CD4+/CD8+ in the reference group after surgery was lower than that before surgery, with statistical significances (P＜0.05). There was no significant difference in the levels of CD4+/CD8+ in the experimental group between after surgery and before surgery (P＞0.05). The levels of CD4+, CD3+ and CD4+/CD8+ in the experimental group after surgery were higher than those in the reference group, and the level of CD8+ in the experimental group after surgery was lower than that in the reference group, the differences were statistically significant (P＜0.05). The total incidence of postoperative complications in the experimental group was lower than that in the reference group, and the difference was statistically significant (P＜0.05). Conclusion Laparoscopic CME treatment for right colon cancer patients is safer, which can reduce the level of tumor markers, has little impact on immune function, and is conducive to postoperative rehabilitation.

Key words： Right colon cancer Complete mesocolic excision Laparoscope Tumor markers T cell subsets

作者简介: 张学圆（1991-），男，江西上饶人，硕士，主要研究方向：胃、肠、疝、甲状腺外科。

引用本文:

张学圆. 腹腔镜全结肠系膜切除术对右半结肠癌患者肿瘤标志物及外周血T细胞含量的影响[J]. 中国当代医药, 2022, 29(8): 91-94.
ZHANG Xueyuan. Influence of laparoscopic complete mesocolic excision on tumor markers and peripheral blood T cell content in patients with right colon cancer. 中国当代医药, 2022, 29(8): 91-94.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I8/91

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