腹腔镜中不同膨腹气体对肿瘤细胞体外及动物模型体内生长的比较

目的 :研究不同膨腹气体 :二氧化碳 (CO2 )、氦气 (He)、一氧化二氮 (N2 O)在模拟气腹条件下对肿瘤细胞体外及动物模型体内生长有无影响。方法 :第 1组用MTT法测定人肝癌细胞株SMMC 772 1在CO2 、He、N2 O“气腹”后及对照组 2 4、4 8、72h的比色值。第 2组观察带瘤Wister大鼠在CO2 、He、N2 O“气腹”后肿瘤生长情况和血清谷丙转氨酶 (AST)、谷草转氨酶 (ALT)、碱性磷酸酶 (ALP)和 -谷氨酰转肽酶 (γ -GT)的变化及穿刺点转移情况。结果 :第 1组实验中 ,CO2 组在“气腹”后 4 8h内肿瘤细胞明显增殖 ,而He组肿瘤细胞生长则显著受抑。第 2组实验中 ,CO2 组肿瘤体积、重量及腹水体积均显著增加 ,血清ALT、AST、ALP值显著升高 ,而He组肿瘤体积、重量及腹水体积均显著减少 ,血清ALT、AST、ALP值较低。N2 O组肿瘤体积、重量及腹水体积和血清ALT、AST、ALP值亦较CO2 组减少。 4组穿刺点转移率没有显著差别。结论 :不同膨腹气体引起的肿瘤细胞生长及代谢功能的改变可能与“气腹”后细胞生存环境 ,特别是腹腔内环境的 pH值改变有关。腹腔镜用于恶性肿瘤患者时 ,应注意CO2 对肿瘤细胞和机体可能产生的不良影响 ,可选择He或N2 O代替

The effects of different gases in laparoscopy on tumor cell growth in vitro and in vivo

Objective:To determine the possible in vitro and in vivo changes of tumor growth after a mimic pneumoperitoneum with insufflating carbon dioxide (CO 2),helium(He) and nitrous oxide (N 2O).Methods: The first experiment of this study is to determine cell growth of hepatocellular carcinoma cell line SMMC 7721 with MTT assay at 24h, 48h and 72h time point in CO 2 group, He group, N 2O group and control group respectively after "pneumoperitoneum". The second experiment of this study is to compare tumor growth, serm ALT,AST, ALP and γ-GT value and port sites metastasis among CO 2 group,He group and control group, N 2O group in a murine model.Results: In the first experiment, at 24h and 48h, tumor growth was stimulated in CO 2 group significantly, and inhibited in He group. In the second expetiment, tumor size, tumor weight and the amount of ascites increased in CO 2 group, serum ALT, AST and ALP value were elevated significantly. In He group, tumor size, tumor weight and the amount of ascites decreased and serum ALT, AST and ALP decreased significantly. The port site metastasis rate did not differ in four groups. Conclusions:The change of tumor growth and metabolic functions may due to pH value changes in extracellular especially the peritoneal circumstance influenced by different gasses. Clinicians should take this result into consideration when choosing the insufflating gas for patients with malignancies. He and N 2O may be alternatives.