摘要
目的研究新辅助化疗对腹腔镜直肠癌根治术后血清肿瘤标志物及肛肠动力学的影响。方法前瞻性选取2017年1月至2019年1月间廊坊市中医医院及廊坊市人民医院收治的82例直肠癌患者作为研究对象,按照随机数字表法将其平均分为观察组与对照组,每组各41例,其中观察组患者行新辅助化疗联合腹腔直肠癌根治术,对照组患者直接行直肠癌根治术。术后随访1年,统计2组手术相关指标[手术方式、手术时间、术中出血量、手术后并发症],术前、术后1周、3个月及6个月血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原199(CA199)及甲胎蛋白(AFP)]及肛肠动力学指标[肛管静息压(ARP)、直肠静息压(RRP)、肛管最大收缩压(MSP)、直肠最大耐受容量(MTV)、直肠顺应性(RC)及直肠肛门抑制反射(RAIR)阳性]变化。结果2组患者的手术方式的选择差异无统计学意义(P>0.05),但观察组保肛病例显著多于对照组,差异有统计学意义(P<0.05),2组患者的手术时间、术后出血量及术后并发症发生率比较,差异均无统计学意义(P>0.05)。术前,2组患者血清肿瘤标志物CEA、CA199及AFP浓度比较,差异均无统计学意义(P>0.05),术后1周、术后3个月及6个月,2组患者血清CEA、CA199及AFP水平均随时间推移逐渐下降,且观察组术后1周、3个月及6个月,血清CEA、CA199及AFP水平均显著低于对照组,差异均有统计学意义(P<0.05)。术后1周、3个月,2组患者肛肠动力学相关指标ARP、MSP、MTV、RC水平及RAIR阳性病例数均较术前显著下降(P<0.05),RRP水平较术前显著上升(P<0.05),但所有指标水平均于术后6个月恢复至术前水平,但2组组间各指标同时间段水平差异均无统计学意义(P>0.05)。观察组患者术后复发率(2.44%)显著低于对照组(14.63%),差异有统计学意义(P<0.05)。结论新辅助化疗能有效提高直肠癌根治术保肛率,对患者肛肠动力学无明显影响,并在预防癌变复发�
Objective To investigate the effect of neoadjuvant chemotherapy on serum tumor markers and anorectal dynamical indexes after laparoscopic radical resection of rectal cancer.Methods From January 2017 to January 2019,82 patients with rectal cancer admitted to Langfang Hospital of Traditional Chinese Medicine and Langfang People's Hospital were prospectively selected as research subjects,and were divided into observation group and control group according to the random number table method,each with 41 cases example.The observation group was received neoadjuvant chemotherapy combined with laparoscopic radical resection of rectal cancer,while control group was received laparoscopic radical resection of rectal cancer only.All patients were followed up for 1 year.The operation related indexes,postoperative serum tumor markers[carcinoembryonic antigen(CEA),carbo hydrate antigen 199(CA199),alpha fetoprotein(AFP)]and anorectal dynamic indexes[anal resting pressure(ARP),rectal resting pressure(RRP),maximal squeeze pressure(MSP),maximal tolerable rectal volume(MTV),rectal compliance(RC),rectoanal inhibitory reflex(RAIR)]were recorded in both groups before operation,1 week,3 months and 6 months after operation.Results There was no statistically significant difference in the choice of surgical methods between the two groups(P>0.05),while the number of anus preserving in observation group was significantly more than that in control group,the difference was statistically significant(P<0.05),and there was no statistically significant difference in the operation time,postoperative blood loss and postoperative complication rate of the two groups of patients(P>0.05).Before surgery,there was no significant difference in serum CEA,CA199 and AFP levels between the two groups of patients(P>0.05).At 1 week,3 months and 6 months after surgery,the levels of serum CEA,CA199 and AFP in the two groups gradually decreased over time,and the levels of serum CEA,CA199,and AFP in the observation group were significantly lower than those in the cont
作者
高登鹏
糜英华
李荣
王相
GAO Deng-peng;MI Ying-hua;LI Rong(Department of General Surgery,Langfang Hospital of Traditional Chinese Medicine,Langfang Hebei 065000,China;Department of General Surgery,Langfang People's Hospital,Langfang Hebei 065000,China.)
出处
《临床和实验医学杂志》
2021年第12期1275-1279,共5页
Journal of Clinical and Experimental Medicine
基金
河北省医学适用技术跟踪项目(编号:GL2012089)
廊坊市科学技术研究与发展计划(编号:2015013046)。
关键词
直肠癌
新辅助化疗
腹腔镜直肠癌根治术
血清肿瘤标志物
肛肠动力学
Rectal cancer
Neoadjuvant chemotherapy
Laparoscopic radical resection of rectal cancer
Serum tumor markers
Anorectal dynamics
