| 巴 高,王志丹,李 琦,田广磊,蒋威华.腔镜下腺体切除术对早期乳腺癌患者血清免疫球蛋白及TNF-α、IL-10水平变化的影响[J].,2021,(21):4118-4122 |
| 腔镜下腺体切除术对早期乳腺癌患者血清免疫球蛋白及TNF-α、IL-10水平变化的影响 |
| Effect of Endoscopic Gland Resection on Serum Immunoglobulin, TNF-α, IL-10 Levels in Patients with Early Breast Cancer |
| 投稿时间：2021-04-07 修订日期：2021-04-30 |
| DOI：10.13241/j.cnki.pmb.2021.21.025 |
| 中文关键词: 腔镜手术 腺体切除术 早期乳腺癌 免疫球蛋白 炎症因子 |
| 英文关键词: Laparoscopic surgery Gland resection Early breast cancer Immunoglobulin Inflammatory factor |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2018DC01C131） |
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| 中文摘要: |
| 摘要 目的：分析腔镜下腺体切除术对早期乳腺癌患者血清免疫球蛋白及TNF-α、IL-10水平的影响，从而对其优势评估。方法：选择2017年2月-2020年2月于本院实施乳腺癌手术患者100例，根据其选择手术方式的不同分为2组：A组（腔镜下腺体切除术，59例）和B组（开放乳房皮下腺体切除术，41例），分别统计患者手术时间、术后拔管时间以及住院时间；术后1个月，取患者外周血，离心取血清，采用免疫比浊法检测患者血清免疫功能相关指标IgM和IgG含量、采用人酶联免疫吸附实验（ELISA）试剂盒检测患者血清中炎症反应指标TNF-α和IL-10含量、统计术后两组患者出现术野皮下出血、皮下积液、乳头乳晕坏死等并发症的例数；术后一年，统计两组患者出现复发和淋巴结转移等现象的例数。结果：A组患者手术时间显著长于B组，而其拔管时间和住院时间均显著短于B组（P＜0.05）。A组并发症发生率（5.00 %）显著高于B组（25.71%）（P<0.05）。术前1 d，两组患者血清免疫指标IgM和IgG水平和炎症反应指标TNF-α和IL-10水平相比差异无统计学意义（P＞0.05），而术后3 d~术后1 m，A组患者血清免疫指标IgM和IgG水平以及抗炎因子IL-10水平均显著高于B组，促炎因子TNF-α水平显著低于B组（P＜0.05）。A组患者术后1年内乳腺癌复发率（3.3%）与B组（10.0%）相比差异不具有统计学意义（P＞0.05）。结论：腔镜下腺体切除术治疗早期乳腺癌具有拔管时间以及术后住院时间短、并发症发生率低等优势，其原因可能与该手术对患者血清免疫球蛋白IgM和IgG及炎症因子TNF-α、IL-10水平影响程度较小、术后恢复较快有关。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the effect of endoscopic gland resection on serum immunoglobulin, TNF-α and IL-10 levels in patients with early breast cancer, so as to evaluate its advantages. Methods: 75 patients undergoing breast cancer surgery were selected and divided into 2 groups according to their choice of surgical methods: group A(laparoscopic surgery, 59 cases) and group B (open breast subcutaneous gland resection, 41 cases). The operation time, postoperative extubation time, and hospital stay were counted. One month after the operation, the peripheral blood of the patient was collected, and the serum was collected by centrifugation. The immunoturbidimetric method was used to detect the serum immune function-related indicators of IgM and IgG. The human enzyme-linked immunosorbent assay (ELISA) kit was used to detect the serum levels of TNF-α and IL-10, and the number of postoperative complications such as subcutaneous hemorrhage, subcutaneous effusion, and nipple and areola necrosis in the two groups of patients was counted; one year after the operation, the number of cases of recurrence and lymph node metastasis in the two groups were counted. Results: The operation time of patients in group A was significantly longer than that in group B, while their extubation time and hospital stay were significantly shorter than those in group B(P<0.05). The incidence of complications in group A(5.00%) was significantly higher than that in group B(25.71%)(P<0.05). 1 day before surgery, there was no significant difference in serum immune index IgM and IgG levels and inflammation response index TNF-α and IL-10 levels between the two groups of patients(P>0.05); From 3 days after operation to 1 m after operation, the serum immune index IgM and IgG levels and the anti-inflammatory factor IL-10 levels of group A patients were significantly higher than those of group B, and the level of pro-inflammatory factor TNF-α was significantly lower than that of group B (P<0.05). The breast cancer recurrence rate (3.3%) of group A patients within 1 year after operation was not statistically different from that of group B (10.0%) (P>0.05). Conclusion: Endoscopic gland resection for the treatment of early breast cancer has the advantages of extubation time, short postoperative hospital stay, and low complication rate. The reason may be related to the lesser effect of the operation on the patient's serum immunoglobulin IgM and IgG, inflammatory factors TNF-α and IL-10 levels, and faster postoperative recovery. |
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