临床外科杂志 ›› 2025, Vol. 33 ›› Issue (5): 482-485.doi: 10.3969/j.issn.1005-6483.20240814

• 论著 • 上一篇    下一篇

食管癌胸腔镜根治术中不同喉返神经旁淋巴结清扫对近期疗效、血清髓系细胞触发受体-1、肿瘤坏死因子受体相关蛋白-1水平及生存质量的影响

  

  1. 710038  西安，空军军医大学第二附属医院胸腔外科 
  • 收稿日期:2024-05-28 接受日期:2024-05-28 出版日期:2025-05-20 发布日期:2025-05-20
  • 通讯作者: 姬翔，Email:jixiang_9001@163.com
  • 基金资助:
    陕西省重点研发计划项目(2018SF-472)

The effect of different RLNLN dissection on the short-term efficacy,serum TREM-1,TRAP1 levels,and quality of life in patients with esophageal cancer undergoing thoracoscopic radical resection

  1. Department of Thoracic Surgery,The Second Affiliated Hospital of Air Force Military Medical University,Xi’an 710038,China
  • Received:2024-05-28 Accepted:2024-05-28 Online:2025-05-20 Published:2025-05-20

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摘要： 目的  探究食管癌(EC)胸腔镜根治术中不同喉返神经旁淋巴结(RLNLN)清扫对临床疗效的影响。方法 2022年1月～2022年10月我院收治EC病人98例，采用简单随机化法分为对照组和研究组，每组各49例。两组均行EC胸腔镜根治术，对照组行常规RLNLN清扫，研究组行改良RLNLN清扫。比较两组手术情况、术后康复情况、手术前后髓系细胞触发受体(TREM）-1、肿瘤坏死因子受体相关蛋白1(TRAP1)、术后并发症，比较两组术后1年复发率和生存率。结果 研究组RLNLN清扫时间为(11.93±3.57)分钟，短于对照组的(17.15±4.28)分钟，双侧RLNLN清扫数量为(7.19±1.24)枚，高于对照组的(5.56±1.10)枚，两组比较差异有统计学意义(P＜0.05)；术后3天、7天，研究组CD3+、CD4+/CD8+高于对照组，CRP、PCT、TREM-1、TRAP1低于对照组，两组比较差异有统计学意义(P＜0.05)；研究组术后并发症、复发率分别为4.08%(2/49)、10.87%(5/46)，低于对照组的18.37%(9/44)、29.55%(13/44)，研究组1年生存率为93.48%(43/46)，高于对照组的77.27%(34/44)，两组比较差异有统计学意义(P＜0.05)。结论 食管癌胸腔镜根治术行改良RLNLN清扫，可增强淋巴结清扫效果，下调TREM-1、TRAP1表达，减轻机体炎症反应，调节免疫功能，降低并发症与复发风险，提高生活质量。

关键词: 食管癌, 胸腔镜根治术, 喉返神经旁淋巴结, 并发症, 复发

Abstract: Objective  To investigate the impact of different lymph node dissection (RLNLN) around the recurrent laryngeal nerve (RLN) on the clinical efficacy of esophagectomy (EC) with thoracoscopic radical surgery.Methods Ninety-eight EC patients were selected from 2022-01 to 2022-10 in our hospital and divided into the control group and the study group,each with 49 cases,using simple randomization method.Both groups underwent EC thoracoscopic radical surgery,with conventional RLNLN clearance in the control group and modified RLNLN clearance in the study group.The operation and postoperative recovery of the two groups were compared,as well as myeloid triggered receptor-1 (TREM-1),tumor necrosis factor receptor-associated protein-1 (TRAP1),and complications before and after the operation,and the recurrence rate and survival rate of the two groups were counted at 1 year after the operation.Results The RLNLN dissection time in the study group was (11.93±3.57) minutes,which was shorter than that in the control group (17.15±4.28) minutes.The number of RLNLN dissections on both sides was (7.19±1.24),which was higher than that in the control group (5.56±1.10),and the differences were statistically significant (P<0.05).Three and seven days after surgery,the CD3+,CD4+/CD8+ of the study group were higher than those of the control group,while CRP,PCT,TREM-1,and TRAP1 were lower than those of the control group,and the differences were statistically significant (P<0.05).The postoperative complication and recurrence rates in the study group were 4.08% (2/49) and 10.87% (5/46),respectively,which were lower than the control group[18.37%(9/44),29.55% (13/44)].Conclusion Thoracoscopic radical resection of esophageal cancer with modified RLNLN dissection can can enhance the effect of lymph node clearance,down-regulate the expression of TREM-1 and TRAP1,reduce the inflammatory response of the body,regulate the immune function,reduce the risk of complications and recurrence,and improve the quality of life.

Key words: esophageal cancer, thoracoscopic radical surgery, paralaryngeal lymph node of the recurrent laryngeal nerve, complication, recurrence

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