CAJ | 학술논문

目的研究腹腔镜胃癌根治术中腹膜间皮细胞ICAM-1和整合素β1表达的变化,探讨腹腔镜胃癌根治术对腹膜转移的可能影响.方法选择2008年4月至8月行腹腔镜胃癌根治术的26例(腹腔镜组)和同期行开腹胃癌根治术的20例(开腹组)患者,根据手术进程分3个时相(手术开始、手术2 h及4 h)取右上腹膜,采用免疫组织化学方法检测腹膜间皮细胞ICAM-1和整合素β1的表达.结果随手术时间的延长,腹腔镜组与开腹组腹膜间皮细胞ICAM-1和整合素β1的阳性表达均呈逐渐增强趋势.其中手术4 h时两组整合紊β1的阳性表达与本组手术开始时相比,差异有统计学意义(P<0.05).但两种黏附分子的阳性表达在3个手术时相中,两组间的差异均无统计学意义(P>0.05).结论与开腹手术相比,腹腔镜胃癌根治术没有增强腹膜间皮细胞ICAM-1和整合素β1的表达.腹腔镜胃癌手术可能并未通过改变腹膜间皮细胞黏附分子的表达而促进胃癌的腹膜转移.
목적 연구복강경위암근치술중복막간피세포ICAM-1화정합소β1표체적변화,탐토복강경위암근치술대복막전이적가능영향.방법 선택2008년4월지8월행복강경위암근치술적26례(복강경조)화동기행개복위암근치술적20례(개복조)환자,근거수술진정분3개시상(수술개시、수술2 h급4 h)취우상복막,채용면역조직화학방법검측복막간피세포ICAM-1화정합소β1적표체.결과 수수술시간적연장,복강경조여개복조복막간피세포ICAM-1화정합소β1적양성표체균정축점증강추세.기중수술4 h시량조정합문β1적양성표체여본조수술개시시상비,차이유통계학의의(P<0.05).단량충점부분자적양성표체재3개수술시상중,량조간적차이균무통계학의의(P>0.05).결론 여개복수술상비,복강경위암근치술몰유증강복막간피세포ICAM-1화정합소β1적표체.복강경위암수술가능병미통과개변복막간피세포점부분자적표체이촉진위암적복막전이.
Objective To investigate the changes of the expression of intercellular adhesion molecule-1 (ICAM-1) and integrin β1 in peritoneal mesothelial cells during laparoscopy-assisted radical gastrectomy (LARG) and to explore the possible effects of LARG on the peritoneal metastasis. Methods From April to August 2008, LARG was performed for 26 patients with gastric cancer (laparoscopy group), while 20 cases underwent open radical gastrectomy (open group). Peritoneum of right upper belly was collected at 3 operation time points (the beginning, 2 hours, 4 hours). The expressions of ICAM-1 and integrin β1 in peritoneal mesothelial cells at 3 time points were detected by immunohistochemistry. Results With the operation prolonging, the expression of ICAM-1 and integrin β1 was increased gradually in both LARG and open groups. The expression of integrin β1 in two groups was obviously increased at 4-hour time point as compared to the beginning (P<0.05). Besides, there were no significant differences of these two adhesion molecules among the three operation time points between two groups (P>0.05). Conclusions Compared with open surgery, LARG is not associated with a greater effect on the expression of ICAM-1 and integrin β1 in peritoneal mesothelial cells, and may not promote peritoneal metastasis of gastric cancer through increasing the expression of adhesion molecule in peritoneal mesothelial cells.