Wang Tao, Liu Xi, Chen Lei, Liang Tao, Ning Xiaokuang
Department of Thoracic Surgery, The First Medical Center of PLA General Hospital, Beijing, China.
Front Surg. 2022 Feb 15;9:842047. doi: 10.3389/fsurg.2022.842047. eCollection 2022.
BACKGROUND: The aim of this study was to analyze the clinical efficacy of different thoracoscopic procedures in patients with non-small cell lung cancer and their correlation with matrix metalloproteinase-7 mRNA (MMPs-7 mRNA) and soluble major histocompatibility complex class I molecule A (sMICA), as well as their effect on T-cell subsets. METHODS: A total of 100 patients with non-small cell lung cancer who received different thoracoscopic surgeries were divided into the Control group (three-port thoracoscopic surgery) and the study group (single-port thoracoscopic surgery). The two groups were evaluated to compare the perioperative indicators, MMPs-7 mRNA, sMICA expression levels, T-cell subsets, postoperative pain, complication rates, and prognostic outcomes at 1-year follow-up. RESULTS: The operation time, blood loss, drainage tube placement time, incision length, and hospital stay in the study group were less than those in the control group ( < 0.05). There was no significant difference in the number of lymph node dissections between the two groups ( > 0.05). After 3 days, the expression levels of MMPs-7 mRNA and sMICA in the study group were lower than those in the control group ( < 0.05); CD4 +, CD8 +, and CD4 +/CD8 + in the study group were higher than those in the control group ( < 0.05). On days 1, 3, and 5, the visual analog score (VAS) of the study group was lower than that of the control group ( < 0.05); there was no significant difference in the complication rate between the two follow-up groups ( > 0.05), in which all patients completed the follow-up. After 1 year of follow-up, there was no significant difference in the tumor-free survival rate and overall survival rate between the two groups ( > 0.05). CONCLUSION: Compared with three-port thoracoscopic surgery, single-port thoracoscopic surgery can improve perioperative expression, shorten hospital stay, reduce serum tumor micrometastasis levels, improve immune metastasis mechanisms and reduce pain, which is of great significance to patients with non-small cell lung cancer. It is an effective, convenient, and safe surgical option that deserves wide clinical reference.
背景：本研究旨在分析不同胸腔镜手术方式对非小细胞肺癌患者的临床疗效，及其与基质金属蛋白酶-7信使核糖核酸（MMPs-7 mRNA）和可溶性主要组织相容性复合体I类分子A（sMICA）的相关性，以及对T细胞亚群的影响。 方法：将100例行不同胸腔镜手术的非小细胞肺癌患者分为对照组（三孔胸腔镜手术）和研究组（单孔胸腔镜手术）。对两组患者的围手术期指标、MMPs-7 mRNA、sMICA表达水平、T细胞亚群、术后疼痛、并发症发生率及1年随访时的预后结果进行评估并比较。 结果：研究组的手术时间、出血量、引流管放置时间、切口长度及住院时间均少于对照组（P<0.05）。两组间淋巴结清扫数量差异无统计学意义（P>0.05）。术后3天，研究组MMPs-7 mRNA和sMICA的表达水平低于对照组（P<0.05）；研究组的CD4+、CD8+及CD4+/CD8+高于对照组（P<0.05）。术后第1、3及5天，研究组的视觉模拟评分（VAS）低于对照组（P<0.05）；两组随访期间并发症发生率差异无统计学意义（P>0.05），所有患者均完成随访。随访1年后，两组间无瘤生存率和总生存率差异无统计学意义（P>0.05）。 结论：与三孔胸腔镜手术相比，单孔胸腔镜手术可改善围手术期指标，缩短住院时间，降低血清肿瘤微转移水平，改善免疫转移机制并减轻疼痛，对非小细胞肺癌患者具有重要意义。是一种有效、便捷且安全的手术方式，值得临床广泛参考。
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