临床外科杂志 ›› 2021, Vol. 29 ›› Issue (8): 754-756.doi: 10.3969/j.issn.1005-6483.2021.08.017

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两种切除术对胃癌病人术后康复及外周血细胞表面PDL1表达的影响

  

  1. 江苏省连云港市第二人民医院普外科
  • 出版日期:2021-08-20 发布日期:2021-08-20

Influence of two kinds of gastrectomies on postoperative rehabilitation and expression of PDL1 on peripheral blood cells of gastric cancer patients

  • Online:2021-08-20 Published:2021-08-20

摘要: 目的:对比完全腹腔镜根治性全胃切除术(TLTG)与腹腔镜辅助根治性全胃切除术(LATG)对胃癌病人术后康复、外周血细胞表面程序性死亡蛋白配体1(PDL1)表达的影响。方法:拟行全胃切除术的病人108例,随机分为TLTG组和LATG组,每组各54例。比较两组术中情况、术后康复,手术前后外周血T淋巴细胞亚群及不同分化病人细胞表面程序性死亡蛋白 1(PD1)及PDL1。结果:两组淋巴结清扫数、术中出血量、食管空肠吻合、总手术时间、下地活动时间、CD8+、细胞表面PD1比较差异无统计意义(P>0.05)。与LATG组比较,TLTG组切口长度、镇痛时间、排气时间、进流(软)食时间、术后住院时间,总的、高、中低分化细胞表面PDL1表达,并发症减少,T淋巴细胞亚群增高,差异有统计学意义(P<0.05)。结论:与LATG比较比,TLTG治疗胃癌疼痛小、康复快,T淋巴细胞亚群及PDL1表达低,应激反应或免疫抑制轻。

关键词: 胃癌根治性切除术, 腹腔镜, 细胞表面程序性死亡蛋白配体1

Abstract: Objective:To compare the influence of totally laparoscopic total gastrectomy(TLTG) and laparoscopicassisted total gastrectomy(LATG) on postoperative rehabilitation and expression of programmed cell deathLigand 1(PDL1) on peripheral blood cells for patients with gastric cancer.Methods:108 patients underwent laparoscopic radical gastrectomy were randomly divided into the TLTG group and LATG group,54 cases/group.The intraoperative conditions,postoperative rehabilitation and complications were compared in 2 groups.Peripheral blood T lymphocyte subsets and cell surface programmed cell death1(PD1)/PDL1 were measured before and after surgery.Results:Both groups had completed the operation.There were no statistically significant differences in the number of lymph node dissections,intraoperative blood loss,esophageal jejunal anastomosis,total surgery time,ground activities,CD8+,and cell surface PD1 in 2 groups(P>0.05).Compared with the LATG group,the incision length,analgesia,first exhaust,inflow(soft) food,postoperative hospital stay,total,high and moderately poorly differentiated cell surface PDL1 expression and complications had induced,T lymphocyte subsets had increased(P<0.05).Conclusion:Compared with LATG,TLTG has the advantages of minimal invasiveness,less postoperative pain and faster recovery in the treatment of gastric cancer,lower T lymphocyte subsets and PDL1,and less stress response or immunosuppression.

Key words: radical surgery of gastric cancer, laparoscopic, programmed cell deathLigand 1

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