文章摘要
蒲振业,陈 亮,朱 全,潘世扬,秦雪君.完全胸腔镜与开放性肺叶切除术治疗的非小细胞肺癌患者围手术期IGFBP-3?VEGF?IL-6水平的比较[J].南京医科大学学报,2011,(7):1027~1031
完全胸腔镜与开放性肺叶切除术治疗的非小细胞肺癌患者围手术期IGFBP-3?VEGF?IL-6水平的比较
Comparison of the perioperative levels of IGFBP-3,VEGF,IL-6 between totally video-assisted thoracoscopic surgery and traditional open surgery in non-small cell lung cancer patients
投稿时间:2011-01-01  
DOI:10.7655
中文关键词: 肺叶切除术  电视胸腔镜  免疫抑制  IL-6  IGFBP-3  VEGF
英文关键词: lobectomy  tVATS  immune suppression  IL-6  IGFBP-3  VEGF
基金项目:江苏省科技厅社会发展项目(BS2007073);江苏省卫生厅重大攻关课题(H200707)
作者单位
蒲振业 南京医科大学第一附属医院胸心外科,江苏 南京 210029 
陈 亮 南京医科大学第一附属医院胸心外科,江苏 南京 210029 
朱 全 南京医科大学第一附属医院胸心外科,江苏 南京 210029 
潘世扬 南京医科大学第一附属医院医学检验科,江苏 南京 210029 
秦雪君 南京医科大学第一附属医院医学检验科,江苏 南京 210029 
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中文摘要:
      目的:通过测定因非小细胞肺癌(NSCLC)行完全胸腔镜肺叶切除术或开放肺叶切除术的患者血清中白细胞介素-6(IL-6)?胰岛素样生长因子结合蛋白-3(IGFBP-3)?血管内皮生长因子(VEGF)的含量,比较两种手术方式对NSCLC患者术后免疫功能及预后的影响?方法:选取NSCLC患者40例,分别行完全胸腔镜肺叶切除术(tVATS组)及传统开放肺叶切除术(TOS组),每组20例?采用酶联免疫吸附法测定两组患者术前?术后第1?3?5天外周血中IL-6?IGFBP-3?VEGF的含量,同时收集其他临床资料,并进行比较?结果:行胸腔镜肺叶切除术的患者与行传统开放肺叶切除术的患者相比,术前血清中的IL-6?IGFBP-3?VEGF的含量无统计学差异(P = 0.328,0.788,0.458);术后第1?3?5天的IL-6及VEGF水平tVATS组均低于TOS组;IGFBP-3水平术后3个时间点tVATS组均高于TOS组?两组无死亡病例,均未出现术后并发症,tVATS组无中转开胸?两组的手术时间?清扫淋巴结站数及个数?术后引流时间?引流量无显著性差异(P > 0.05)?tVATS组的术中失血量?术后疼痛评分?术后下床活动日?术后住院天数明显低于TOS组,有显著性差异(P < 0.05)?结论:胸腔镜肺叶切除较开放肺叶切除术对患者手术创伤小?免疫功能影响轻,对于术后肿瘤转移?复发的影响较小,可以改善患者的预后,为后续治疗提供有利条件?
英文摘要:
      Objective:To compare perioperative effect of lobectomy by totally video-assisted thoracoscopic surgery(tVATS) or traditional open surgery(TOS) on immunologic function and prognostic factors of non-small cell lung cancer(NSCLC) patients. Methods:Forty NSCLC patients underwent lobectomy by TOS or tVATS were selected,20 patients in each group. The serum levels of interleukin-6(IL-6),insulin-like growth factor binding protein-3(IGFBP-3) and vascular endothelial growth factor (VEGF) of patients before surgery and at the 1st,3rd and 5th day after surgery were determined using the ELISA. At the same time,the clinical data were collected and compared between two groups. Results:There was no significant difference in the preoperative serum levels of IL-6,IGFBP-3 and VEGF between two groups. The levels of IL-6 and VEGF at the three postoperative time points in tVATS group were significantly lower than those in TOS group. The levels of IGFBP-3 at the three postoperative time points in tVATS group were significantly higher than those in TOS group. There were no death and no serious complications in two groups. No conversion to thoracotomy occurred in tVATS group. There was no significant difference in operative time,numbers of stations and numbers of lymph node dissected,the chest drainage days and drainage volume after surgery between two groups. In tVATS group,intraoperative blood loss,postoperative pain score,days of getting out of bed and postoperative hospital stay were significantly lower than those in TOS group. Conclusion:Comparing with TOS,the effect of lobectomy with tVATS on the immune suppression and the influence on tumor metastasis and recurrence is much less. It can improve the prognosis of patients,provide favorable conditions for the subsequent treatment.
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