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腹腔镜与开放根治性胃癌切除术患者腹腔引流液中肿瘤标志物的差异

Disparities of tumour markers in intraperitoneal drainage fluid between laparoscopic and open radical gastrectomy for gastric cancer.

作者信息

Guo Jian, Zheng Longzhi, Chen Junwei, Lin Wei

机构信息

Department of Gastrointestinal Surgery and Gastrointestinal Surgery Research Institute, The Affiliated Hospital of Putian University, Putian, Fujian, China.

The School of Clinical Medicine, Fujian Medical University, University Town, Fuzhou, Fujian, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2024 Jun;19(2):233-242. doi: 10.5114/wiitm.2024.139509. Epub 2024 May 8.

Abstract

INTRODUCTION

Despite the remarkable progress in minimally invasive surgery, the potential association between laparoscopic gastrectomy and the risk of peritoneal metastasis remains uncertain.

AIM

To investigate variations in tumour markers in intraperitoneal drainage fluid between laparoscopic radical gastrectomy and open radical gastrectomy for gastric cancer.

MATERIAL AND METHODS

A total of 106 patients diagnosed with gastric cancer between July 2018 and November 2020 were included in this study, 45 of whom underwent laparoscopic radical gastrectomy (laparoscopic group) and 61 underwent open radical gastrectomy (open group). Variations in the levels of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 199 (CA199), and -fetoprotein (AFP) in the intraperitoneal drainage fluid were compared and analysed on postoperative days (PODs) 1, 2, 3, and 5 between the two groups. Additionally, the postoperative 3-year survival rates between the two groups were compared and analysed.

RESULTS

No significant differences in CEA, CA199, and AFP levels in the intraperitoneal drainage fluid were observed between the two groups on postoperative days (PODs) 1, 2, 3, and 5 (p > 0.05). However, the level of CA125 in the intraperitoneal drainage fluid of the laparoscopic group was notably higher than that of the open group on POD 2 (p < 0.05); however, there were no significant differences between the two groups on PODs 1, 3, and 5 (p > 0.05). There was no significant difference in the 3-year postoperative survival rates between the two groups.

CONCLUSIONS

There were no significant differences in CEA, CA125, CA199, and AFP levels in the intraperitoneal drainage fluid between laparoscopic radical gastrectomy and open radical gastrectomy for gastric cancer, confirming from another perspective that laparoscopic radical gastrectomy does not increase the risk of intraperitoneal metastasis.

摘要

引言

尽管微创手术取得了显著进展,但腹腔镜胃切除术与腹膜转移风险之间的潜在关联仍不明确。

目的

探讨腹腔镜根治性胃切除术与开放性根治性胃切除术治疗胃癌时腹腔引流液中肿瘤标志物的变化。

材料与方法

本研究纳入了2018年7月至2020年11月期间共106例诊断为胃癌的患者,其中45例行腹腔镜根治性胃切除术(腹腔镜组),61例行开放性根治性胃切除术(开放组)。比较并分析两组术后第1、2、3和5天腹腔引流液中癌胚抗原(CEA)、癌抗原125(CA125)、癌抗原199(CA199)和甲胎蛋白(AFP)水平的变化。此外,比较并分析两组术后3年生存率。

结果

两组术后第1、2、3和5天腹腔引流液中CEA、CA199和AFP水平无显著差异(p>0.05)。然而,腹腔镜组术后第2天腹腔引流液中CA125水平明显高于开放组(p<0.05);但两组在术后第1、3和5天无显著差异(p>0.05)。两组术后3年生存率无显著差异。

结论

腹腔镜根治性胃切除术与开放性根治性胃切除术治疗胃癌时,腹腔引流液中CEA、CA125、CA199和AFP水平无显著差异,从另一个角度证实腹腔镜根治性胃切除术不会增加腹腔转移风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/924d/11223551/5f488e9c66b3/WIITM-19-54102-g001.jpg

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