腹腔镜微创远端胃癌D2根治术治疗老年胃癌的效果及其对免疫功能、低氧诱导因子—1α(1)
[摘要] 目的 探讨腹腔镜微创远端胃癌D2根治术治疗老年胃癌的效果及其对免疫功能、低氧诱导因子-1α(HIF-1α)和结肠癌转移相关基因1(MACC1)表达的影响。 方法 选取2009年2月～2013年8月于四川省崇州市人民医院诊治的78例老年胃癌患者为研究对象，采用随机数字表法分为腹腔镜微创远端胃癌D2根治术组(微创组)和开腹远端胃癌D2根治术组(传统组)，每组各39例，比较两组患者的近远期疗效、并发症情况、治疗前后免疫功能、HIF-1α和MACC1表达水平。 结果 微创组患者术中出血量少于传统组，胃肠道功能恢复时间短于传统组，并发症发生率低于传统组(P < 0.05)；两组患者手术时间和淋巴结清扫数目比较，差异无统计学意义(P > 0.05)。两组患者平均生存时间、1年生存率、2年生存率和局部复发与转移率比较，差异无统计学意义(P > 0.05)。两组患者治疗后IgM、IgG、CD4+和CD4+/CD8+水平较治疗前升高，CD8+、HIF-1α和MACC1水平较治疗前降低，且微创组上述指标的改善程度明显优于传统组(P < 0.05)；两组患者治疗前后IgA和CD3+水平比较，差异无统计学意义(P > 0.05)。 结论 腹腔镜微创远端胃癌D2根治术可显著提高老年胃癌患者的近期临床疗效，改善患者免疫功能，抑制肿瘤相关基因HIF-1α和MACC1的表达。
[关键词] 腹腔镜；胃癌；免疫功能；低氧诱导因子-1α；结肠癌转移相关基因1
[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210(2016)03(b)-0021-04
[Abstract] Objective To explore efficacy of laparoscopic minimally invasive distal D2 gastrectomy in the treatment of elderly gastric cancer and its influnce on the expression of immune function， hypoxia inducible factor-1α (HIF-1α) and metastasis-associated in colon cancer 1 (MACC1). Methods 78 cases of elderly patients with gastric cancer from February 2009 to August 2013 in People′s Hospital of Chongzhou City， Sichuan Province were selected as research objects and divided into laparoscopic minimally invasive distal D2 radical resection group (minimally invasive group) and D2 radical resection group (traditional group) by using the random number table method， each group had 39 cases. The short- term and long-term clinical efficacy， complications， the immune function and the levels of HIF-1α and MACC1 before and after treatment were compared between two groups. Results The intraoperative bleeding volume of minimally invasive group was less than that of traditional group， gastrointestinal function recovery time of minimally invasive group was shorter than that of traditional group， incidence rate of adverse reaction in minimally invasive group was lower than that in traditional group (P < 0.05). There were no significant differences on the operation time and the number of lymph node dissection between two groups (P > 0.05). The average survival time， 1 year survival rate， 2 year survival rate and local recurrence rate between two groups were compared， with no significant differences (P > 0.05). After treatment， the levels of IgM， IgG， CD4+ and CD4+/CD8+ in two groups were significantly higher than those before treatment， the levels of CD8+， HIF-1α and MACC1 in two groups were significantly lower than those before treatment， the improvement of these indicators of minimally invasive group were better than those in traditional group (P < 0.05). There were no significant differences on the levels of IgA and CD3+ in two groups before and after treatment (P > 0.05). Conclusion Laparoscopic minimally invasive distal D2 gastrectomy can significantly improve the short-term clinical efficacy of elderly patients with gastric cancer， improve the immune function and inhibit the expression of tumor related genes HIF-1α and MACC1., 百拇医药(汪昱 游红勇 刘东涛 陈智敏 赵昕波 李海 孙坤)
[关键词] 腹腔镜；胃癌；免疫功能；低氧诱导因子-1α；结肠癌转移相关基因1
[中图分类号] R735.2 [文献标识码] A [文章编号] 1673-7210(2016)03(b)-0021-04
[Abstract] Objective To explore efficacy of laparoscopic minimally invasive distal D2 gastrectomy in the treatment of elderly gastric cancer and its influnce on the expression of immune function， hypoxia inducible factor-1α (HIF-1α) and metastasis-associated in colon cancer 1 (MACC1). Methods 78 cases of elderly patients with gastric cancer from February 2009 to August 2013 in People′s Hospital of Chongzhou City， Sichuan Province were selected as research objects and divided into laparoscopic minimally invasive distal D2 radical resection group (minimally invasive group) and D2 radical resection group (traditional group) by using the random number table method， each group had 39 cases. The short- term and long-term clinical efficacy， complications， the immune function and the levels of HIF-1α and MACC1 before and after treatment were compared between two groups. Results The intraoperative bleeding volume of minimally invasive group was less than that of traditional group， gastrointestinal function recovery time of minimally invasive group was shorter than that of traditional group， incidence rate of adverse reaction in minimally invasive group was lower than that in traditional group (P < 0.05). There were no significant differences on the operation time and the number of lymph node dissection between two groups (P > 0.05). The average survival time， 1 year survival rate， 2 year survival rate and local recurrence rate between two groups were compared， with no significant differences (P > 0.05). After treatment， the levels of IgM， IgG， CD4+ and CD4+/CD8+ in two groups were significantly higher than those before treatment， the levels of CD8+， HIF-1α and MACC1 in two groups were significantly lower than those before treatment， the improvement of these indicators of minimally invasive group were better than those in traditional group (P < 0.05). There were no significant differences on the levels of IgA and CD3+ in two groups before and after treatment (P > 0.05). Conclusion Laparoscopic minimally invasive distal D2 gastrectomy can significantly improve the short-term clinical efficacy of elderly patients with gastric cancer， improve the immune function and inhibit the expression of tumor related genes HIF-1α and MACC1., 百拇医药(汪昱 游红勇 刘东涛 陈智敏 赵昕波 李海 孙坤)