胸腔镜手术治疗非小细胞肺癌患者的近期疗效及对血清Pentraxin-3、HE4水平的影响

摘要

目的 探讨胸腔镜手术治疗非小细胞肺癌患者的近期疗效及对血清穿透素-3(Pentraxin-3)、人附睾蛋白4(HE4)水平的影响.方法 选择成都军区总医院胸外科2013年1月-2014年7月诊治的肺癌患者96例,按随机数字表法分为2组,对照组48例行传统开胸术,研究组48例行胸腔镜手术,比较2组围手术情况、近期疗效,检测前清蛋白(PA)及白细胞(WBC)水平,肺功能[第1秒用力呼气容积(FEV1)、每分钟通气量(MV)],Pentraxin-3及HE4水平,记录2组的并发症等.结果 2组手术时间、淋巴结清扫数目比较差异无统计学意义(t=0.499、1.016,P＞ 0.05);研究组切口长度、出血量、镇痛时间、住院时间优于对照组,差异有统计学意义(t=22.539、22.787、2.792、5.968,P＜0.05).2组第1年、2年生存率及复发率比较差异无统计学意义(x2=0.546、1.094、0.477、0.944,P ＞0.05).术后,研究组FEV1为(65.31±8.95)％,MV为(123.79±25.43)L,均显著高于对照组的(53.79±7.20)％和(105.87±18.24)L,差异有统计学意义(t=6.948、3.967,P＜0.05).研究组PA高于对照组[(225.41±49.20) mg/L vs.(158.53 ±48.27) mg/L,t=6.723,P＜0.05],WBC低于对照组[(12.68±2.75)×109/L vs.(15.49±3.27)×109/L,t=4.557,P＜0.05],研究组Pentraxin-3、HE4低于对照组[(3.28 ±0.73)g/L vs.(5.59±1.30)g/L,(104.67±19.24) pmol/L vs.(125.76 ±24.21) pmol/L],差异有统计学意义(t=10.734、4.725,P＜0.05).研究组并发症率低于对照组(8.33％ vs.35.42％,x2=10.301,P＜0.05).结论 胸腔镜手术治疗非小细胞肺癌患者近期疗效值得肯定,且能够降低血清Pentraxin-3、HE4水平.%Objective To investigate the short-term efficacy of video-assisted thoracoscopic surgery (VATS) in the treatment of patients with non-small cell lung cancer and the effect of serum levels of 3 (Pentraxin 3) and human epididymis protein (HE4).Methods 96 cases of patients with lung cancer in our hospital from January 2013 and July 2013 were the diagnosed and treated,48 routine traditional open heart surgery as the control group,48 routine thoracoscope surgery as test group,two groups' of surgery,the recent curative effect,prealbumin (PA) and white blood cell (WBC) levels and pulmonary function [forced expiratory volume in 1 second (FEV1),per minute ventilation (MV)],Pentraxin 3 and HE4 levels,complications were compared.Results The operation time and lymph node cleaning number of two groups' difference were not statistically significant (t =0.499,t =1.016,P ＞ 0.05);The incision length,blood loss,analgesic time,length of hospital stay of test group was better than that of control group,the difference was statistically significant (t =22.539,t =22.787,t =2.792,t =5.968,all P ＜ 0.05).The 1 year,2 year survival rate,recurrence rate of two groups were not significant different (x2 =0.546,x2 =1.094,x2 =0.477,x2 =0.944,all P ＞ 0.05).After surgery,the FEV1 (65.31 ± 8.95) ％,MV (123.79 ± 25.43) L of test group were higher than the control group (53.79 ± 7.20) ％,(105.87 ± 18.24) L,the difference was statistically significant (t =6.948,t =3.967,P ＜0.05).Test PA (225.41 ± 49.20) mg/L of test group was higher than the control group (158.53 ±48.27)mg/L,the WBC (12.68 ± 2.75) × 109/L of test group was lower than the control group (15.49 ± 3.27) × 109/L,the Pentraxin 3 (3.28 ± 0.73) g/L,HE4 (104.67 ± 19.24) pmol/L of test group was lower than the control group (5.59 ± 1.30) g/L,(125.76 ± 24.21) pmol/L,the difference was statistically significant (t =6.723,t =4.557,t =10.734,t =4.725,P ＜0.05).The complication rate 35.42％ (17/48) of test group was lower than the control group 8.33％ (4/48) (x2 =10.301,P ＜ 0.05).Conclusion Thoracoscope surgery in patients with lung cancer in the near future curative effect is positive,it can reduce serum Pentraxin 3,HE4 levels.