腹腔镜下CME术对右半结肠癌患者VEGF、CCSA－2和sICAM－1的影响

目的探讨腹腔镜下CME术在右半结肠癌患者中的应用效果及其对患者血管内皮生长因子(VEGF)、结肠癌特异性抗原－2(CCSA－2)和可溶性细胞粘附因子－1(sICAM－1)的影响。 方法回顾性分析2012年3月至2014年10月就诊的82例右半结肠癌患者，按照手术方式不同分为开腹组和腹腔镜组各41例。用SPSS 19.0对结果进行统计学分析，手术指标、肿瘤标志物水平用( ±s)表示，采用独立t检验，3年复发率及病死率用χ²检验，当P<0.05时差异有统计学意义。 结果腹腔镜组手术出血量、肛门排气时间、术后引流液量、住院天数均低于开腹组(P<0.05)，而两组手术用时和淋巴结清扫数目比较无统计学差异(P>0.05)；两组患者术后第3天VEGF、CCSA－2和sICAM－1水平均较术前升高，但腹腔镜组明显低于开腹组(P<0.05)；术后腹腔镜组并发症总发生率12.2%低于开腹组46.3%，(P<0.05)；术后随访腹腔镜组3年疾病复发率(9.8%)及3年病死率(4.9%)均低于开腹组(比例分别为31.7%、24.4%)(P<0.05)。 结论腹腔镜下CME术对右半结肠癌患者的临床效果较好，可以有效降低患者VEGF、CCSA－2和sICAM－1水平，术后并发症较少，短期疗效更为显著，同时术后3年疾病复发率及3年病死率均较低，其患者远期预后也较好。

Effect of Laparoscopic CME In Patients With Right Colon Cancer and Its Effect On VEGF,CCSA-2 and sICAM-1

ObjectiveTo investigate the effect of laparoscopic CME in patients with right colon cancer and its effect on vascular endothelial growth factor(VEGF), colon cancer-specific antigen-2(CCSA-2) and soluble intercellular adhesion molecule-1(sICAM-1). MethodsA retrospective analysis of 82 patients with right colon cancer who were treated in our hospital from March 2012 to October 2014 were retrospectively analyzed. According to the different surgical methods, 41 cases were divided into laparotomy group and 41 cases were divided into laparoscopic group. SPSS 19.0 was used to analyze the results. Surgical data and tumor markers were expressed as ( ±s), and compared with independent t-test, the recurrence rate and mortality within 3 years were compared with χ² test. The difference was statistically significant at P<0.05. ResultsThe amount of bleeding, the time of anus exhaust, the amount of postoperative drainage volume and the days of hospitalization in the laparoscopic group were all lower than those in the laparotomy group (P<0.05), while there were no significant difference between the two groups in the operation time and the number of lymph node dissection (P>0.05). The levels of VEGF, CCSA-2 and sICAM-1 in the two groups were significantly increased at the third day after operation, and the levels of these indexes in the laparoscopic group were significantly lower than those in the laparotomy group (P<0.05). The total incidence of postoperative complications of the laparoscopic group(12.2%) was lower than that of the laparotomy group(46.3%) (P<0.05). The disease recurrence rate (9.8%) and mortality rate (4.9%) within postoperative 3-years of laparoscopic group were lower than the laparotomy group (31.7% and 24.4% respectively) (P<0.05). ConclusionThe clinical effect of laparoscopic CME on right colon cancer patients is good, which can effectively reduce the levels of VEGF, CCSA-2 and sICAM-1 in patients with less postoperative complications, its short-term curative effect is better, and its disease recurrence rate and mortality within postoperative 3-years are lower, which can achieve better long-term prognosis.