腹腔镜肝癌切除术对患者炎症应激反应及microRNA-302水平的影响

Effect of laparoscopic liver resection for cancer on inflammatory response and microRNA-302 level

摘要:

目的 探讨腹腔镜肝癌切除术对患者炎症应激反应及microRNA-302（miR-302）水平的影响。方法 选取2018年2月—2021年3月天水市中西医结合医院接受治疗的106例肝癌患者，根据自愿原则分为腹腔镜组和开腹组，每组53例。开腹组接受开腹肝切除术，腹腔镜组接受腹腔镜肝癌切除术。比较两组围手术期相关指标（手术时间、术中出血量、切口长度、住院时间）、炎症应激反应［白细胞介素-6（IL-6）、白细胞介素-2（IL-2）、C反应蛋白（CRP）］、肝功能［谷丙转氨酶（ALT）、总胆红素（TBIL）、谷草转氨酶（AST）］miR-302表达水平。结果 腹腔镜组术中出血量较开腹组低，切口长度、住院时间较开腹组短，手术时间较开腹组长（P <0.05）。两组患者术前IL-2、IL-6、CRP水平比较，差异无统计学意义（P >0.05）。腹腔镜组术后IL-6、CRP较开腹组低，IL-2较开腹组高（P <0.05）。两组患者手术前ALT、AST、TBIL水平比较，差异无统计学意义（P >0.05）。腹腔镜组术后ALT、AST、TBIL水平较开腹组低（P <0.05）。两组患者术前miR-302相对表达量比较，差异无统计学意义（P >0.05）。腹腔镜组术后miR-302相对表达量较开腹组低（P <0.05）。结论 相比开腹肝切除术，腹腔镜肝癌切除术具有微创优势，可有效降低机体炎症应激反应水平，保留残余肝功能，一定程度降低miR-302水平。

Abstract:

Objective To explore the effect of laparoscopic liver resection for cancer on inflammatory response and microRNA-302 level.Methods The study included 106 patients with liver cancer who were treated in our hospital from June 2018 to May 2021. They were divided into laparoscopic group (53 cases) and open group (53 cases) according to the surgical approach as they might wish. The perioperative indicators (operative duration, intraoperative blood loss, incision length, and length of hospital stay), inflammatory response [the expression of interleukin-6 (IL-6), interleukin-2 (IL-2), and C-reactive protein (CRP)], liver function [alanine transaminase (ALT), total bilirubin (TBIL), and glutamate transaminase (AST)] and microRNA-302 level were compared between the two groups.Results The intraoperative blood loss was less, incision length and length of hospital stay were shorter and the operative duration was longer in the laparoscopic group compared with the open group (P < 0.05). The preoperative levels of IL-2, IL-6 and CRP were not different between the two groups (P > 0.05). After surgery, serum IL-6 and CRP in the laparoscopic group were lower than those in the open group, while IL-2 was higher in the laparoscopic group than that in the open group (P > 0.05). The ALT, AST, and TBIL levels were not different between the two groups before the surgery (P > 0.05), but were lower in the laparoscopic group postoperatively (P < 0.05). The expression of microRNA-302 after surgery was lower than that before surgery in both groups (P < 0.05). There was no difference in preoperative microRNA-302 expression between the two groups, whereas microRNA-302 expression after surgery was lower in laparoscopic group (P < 0.05).Conclusions Compared with open surgery, laparoscopic liver resection for cancer is less invasive, and can effectively reduce inflammatory response, preserve the function of residual liver, and regulate microRNA-302 level to a certain extent.