Department of Gastroenterological Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka, Yufu, Oita 879-5593, Japan.
Surg Endosc. 2010 Jun;24(6):1427-33. doi: 10.1007/s00464-009-0793-8. Epub 2009 Dec 30.
Surgical impact may be associated with enhanced tumor growth and chemoresistance. This study aimed to evaluate the effect of surgical impact on the mRNA expression of survivin, epidermal growth factor receptor (EGFR), and human epidermal receptor (HER2) in tumors after pneumoperitoneum versus laparotomy.
Nude mice were inoculated intraperitoneally with human gastric cancer cells (MKN45). Then laparotomy, carbon dioxide (CO(2)) pneumoperitoneum, and anesthesia alone were performed randomly, after which EGFR, HER2, and survivin mRNA expression using reverse transcription-polymerase chain reaction (RT-PCR) was evaluated.
The expression of EGFR and HER2 mRNA increased significantly after the experiment. However, it was higher after laparotomy than after CO(2) pneumoperitoneum at almost all examined time points. Survivin mRNA expression increased significantly in the first 48 h, then returned to the control level. It was higher after laparotomy than after CO(2) pneumoperitoneum 48 h after the surgical procedures.
The expression of EGFR, HER2, and survivin increased after each surgical procedure. However it was lower after CO(2) pneumoperitoneum than after laparotomy. This might be associated with changes in the chemosensitivity of the remnant cancer cells after surgery, supporting the use of minimally invasive surgery for cancer.
手术创伤可能会增强肿瘤生长和化疗耐药性。本研究旨在评估气腹与剖腹手术对肿瘤中存活素、表皮生长因子受体（EGFR）和人表皮受体（HER2）mRNA 表达的影响。
将人胃癌细胞（MKN45）腹腔内接种于裸鼠。然后随机进行剖腹手术、二氧化碳（CO2）气腹和单纯麻醉，使用逆转录-聚合酶链反应（RT-PCR）评估 EGFR、HER2 和存活素 mRNA 的表达。
实验后 EGFR 和 HER2 mRNA 的表达明显增加。然而，在几乎所有检查的时间点，剖腹手术后的表达均高于 CO2 气腹后。存活素 mRNA 表达在最初的 48 小时内显著增加，然后恢复到对照水平。手术后 48 小时，剖腹手术后的表达高于 CO2 气腹。
每次手术都会增加 EGFR、HER2 和存活素的表达。然而，CO2 气腹后低于剖腹手术后。这可能与手术后残留癌细胞的化疗敏感性变化有关，支持使用微创手术治疗癌症。
