不同手术入路途径对胸中段老年食管癌患者VEGF-HIFα-PTEN表达水平及肿瘤转移的影响

分析不同手术入路途径对胸中段老年食管癌患者的综合疗效,将160例患者按照不同治疗方法分为左胸路径组70例和右胸路径组90例。左胸路径组患者行左胸两切口入路手术,右胸路径组患者行右胸三切口手术入路。结果显示:与左胸路径组相比,右胸路径组的手术时间、术中出血量及VAS评分明显升高(P<0.05),淋巴结清扫率明显升高(P<0.05),1年转移率、3年转移率明显降低而1年生存率和3年生存率明显升高(P<0.05),而术后引流时间及住院时间无明显差异性；两组患者治疗后血清中VEGF、VEGFR、HIFα水平均明显降低而PTEN水平明显升高(P<0.05),且右胸路径组患者的上述指标变化更显著(P<0.05)。因此,不同手术入路途径对胸中段老年食管癌患者的临床效果及血清中VEGF-HIFα-PTEN表达水平和肿瘤转移有不同影响,临床上应合理选择。

Effects of different surgical approaches on the expression of vascular endothelial growth factor-HIFalpha-PTEN and metastasis in middle thoracic esophageal cancer in elderly patients

To investigate the effects of different surgical approaches on the expression of vascular endothelial.160 patients were divided into two groups according to the treatment method:left thoracic pathway group (n=70) and right thoracic pathway group (n=90). The patients in the left thoracic approach group underwent two incisions of left thoracic approach. The patients in the right thoracic pathway group were operated through the right thoracic three-incision approach. The results showed that compared with the left thoracic approach group, the operation time, intraoperative bleeding volume and VAS score of the right thoracic approach group were significantly increased (P<0.05), and the lymph node dissection rate was significantly increased (P<0.05). The 1-year metastasis rate and 3-year metastasis rate decreased significantly, while the 1-year survival rate and 3-year survival rate increased significantly (P<0.05). There was no significant difference in drainage time and hospitalization time (P>0.05). After treatment, the serum levels of vascular endothelial growth factor, vascular endothelial growth factor R and HIFalpha in both groups were significantly decreased, while PTEN levels were significantly increased (P<0.05). The changes of above indexes were more significant in the right thoracic pathway group (P<0.05). So Different surgical approaches have different effects on the clinical effect of middle thoracic esophageal cancer in elderly patients and the level of serum expression of vascular endothelial growth factor-HIFalpha-PTEN and the metastasis of esophageal cancer.