妇科腹腔镜手术对机体腹膜IL-6表达的影响

目的探讨妇科二氧化碳气腹腹腔镜手术对腹膜IL-6表达的影响。方法对60例子宫肌瘤或单纯卵巢囊肿患者(排除腹膜炎症)随机分别进行腹腔镜手术(30例)和开腹手术(30例),于手术0、30、60、90和120min分别采集壁层腹膜,抽提总RNA,以IL-6引物进行RT-PCR;同时取腹膜组织制成悬浮液,行ELISA法检测,检测IL-6表达情况。结果腹腔镜组IL-6在手术期间表达且有下降趋势,120min时IL-6降低,差异有显著性(与0min比较,P<0.05)。开腹组IL-6在各个时间点均有表达且持续升高,IL-6在手术60min和90min与0min比较差异有显著性(P<0.05),手术120min与0min比较,差异有非常显著性(P<0.01),120minIL-6蛋白含量较0min升高约1.7倍。腹腔镜组与开腹组同一时间点比较,IL-6蛋白含量在60min有统计学意义(P<0.05),90min和120min差异有非常显著性(P<0.01)。结论二氧化碳气腹腹腔镜组腹膜细胞因子IL-6的表达下降,开腹组增高,腹腔镜组低于开腹组,说明腹腔镜手术导致腹腔局部免疫力降低,可能在恶性肿瘤腹腔镜手术腹腔转移中起重要作用。与镜下腹腔恶性肿瘤的转移率高相符,说明黏附分子在此过程中起重要作用。

Effect of laparoscopic surgery on expression of peritoneum cytokine

Objective To clarify the impact of carbon dioxide pneumoperitoneum during laparoscopic surgery on expression of IL-6 in peritoneum.Methods 60 patients with myoma of uterus or ovarian pure cyst(excluding peritonitis)were randomized to operate by laparoscopic surgery(n =30)or laparotomy surgery(n =30).The parietal peritoneum was resected from each patients in different time(0,30,60,90 and 120 min),total RNA was extracted,and expression of IL-6mRNAs was examined by RT-PCR.The supernatants of peritoneum were measured by ELISA.Results The expression of IL-6 was found decreasingly at all operating time in laparoscopic surgery group,and the expression of IL-6 decreased at 120 min(P <0.05,vs 0 min).The expression of IL-6 could be found increasingly at all the time in the laparotomy surgery.The protein content of IL-6 was higher(P <0.05,60 min and 90 min vs 0 min;P <0.01,120 min vs 0 min).The protein content of IL-6 at 120 min increased about 1.7 times.There was statistically significant difference of protein content of IL-6 between two groups(P <0.05,60 min;P <0.01,90 min and 120 min).Conclusion The expression of peritoneal IL-6 decreased in laparoscopic surgery and was lower than that in open surgery group(which increased),which leaded to the depression of local Immune of the abdominal cavity,and benefited to metastasis of malignant tumor in laparoscopic surgery.