Sun Chuan-Peng, Bai Yan, Jiang Jin-Qiang, Wu Jian-Lin
General Surgery, Yantai Zhifu Hospital Yantai 264000, Shandong Province, China.
General Surgery, Tianjin Fifth Central Hospital Tianjin 300450, China.
Am J Transl Res. 2021 Nov 15;13(11):12887-12896. eCollection 2021.
To investigate the effects of laparoscopic radical surgery on the treatment of colorectal cancer (CRC) and explore the correlations of vascular endothelial growth factor (VEGF) and transforming growth factor-β1 (TGF-β1) with prognosis.
The clinical data of 210 patients with CRC admitted to the Yantai Zhifu Hospital from February 2015 to February 2018 were analyzed retrospectively. Among them, 110 patients were treated with laparoscopic radical surgery and assigned to the observation group, and the rest 100 patients were treated with routine open surgery and included in the open group. The two groups were compared in terms of operation time (OT), intraoperative blood loss (IBL), postoperative exhaust time (PET), length of hospital stays (LOS) and incidence of complications. Patients were also followed up for 3 years to count their survival rates. Serum expression levels of VEGF and TGF-β1, detected by enzyme-linked immunosorbent assays (ELISAs), were compared before and after treatment, and their correlations with patients' clinicopathological data and prognosis were analyzed.
Compared with the open group, patients in the observation group had longer OT, but lower IBL, PET, LOS, and overall incidence of complications. In the observation group, VEGF and TGF-β1 expression after treatment was remarkably lower than that before treatment and that in the open group. A 3-year survival rate of 80.0% was observed in the observation group. Univariate analysis showed that serum VEGF and TGF-β1 expression levels were closely related to Dukes staging and lymph node metastasis (LNM) (<0.05). The Log-Rank test showed that the survival rate of patients with high VEGF and TGF-β1 expression was remarkably lower than that of those with low expression (<0.05). According to Cox model multivariate analysis, Dukes staging, LNM, surgical methods and high VEGF and TGF-β1 expression were all independent risk factors for the prognosis of CRC patients (<0.05).
Laparoscopic radical surgery is effective and safe in treating CRC. VEGF and TGF-β1 are highly expressed in the serum of CRC patients, and are closely related to the tumor staging, LNM and prognosis of patients, which are of great significance for evaluating the condition and prognosis of CRC patients.
探讨腹腔镜根治术治疗结直肠癌（CRC）的效果，并探究血管内皮生长因子（VEGF）和转化生长因子-β1（TGF-β1）与预后的相关性。
回顾性分析2015年2月至2018年2月在烟台市芝罘医院收治的210例CRC患者的临床资料。其中，110例行腹腔镜根治术患者作为观察组，其余100例行常规开放手术患者纳入开放组。比较两组手术时间（OT）、术中出血量（IBL）、术后排气时间（PET）、住院时间（LOS）及并发症发生率。对患者进行3年随访并统计生存率。采用酶联免疫吸附测定（ELISA）法检测治疗前后血清VEGF和TGF-β1表达水平，并分析其与患者临床病理资料及预后的相关性。
与开放组相比，观察组患者OT较长，但IBL、PET、LOS及并发症总发生率较低。观察组治疗后VEGF和TGF-β1表达明显低于治疗前及开放组。观察组3年生存率为80.0%。单因素分析显示，血清VEGF和TGF-β1表达水平与Dukes分期及淋巴结转移（LNM）密切相关（<0.05）。Log-Rank检验显示，VEGF和TGF-β1高表达患者的生存率明显低于低表达患者（<0.05）。根据Cox模型多因素分析，Dukes分期、LNM、手术方式及VEGF和TGF-β1高表达均为CRC患者预后的独立危险因素（<0.05）。
腹腔镜根治术治疗CRC安全有效。VEGF和TGF-β1在CRC患者血清中高表达，与患者肿瘤分期、LNM及预后密切相关，对评估CRC患者病情及预后具有重要意义。
