Laparoscopic surgery minimizes the release of circulating tumor cells compared to open surgery for hepatocellular carcinoma
Laparoscopic surgery minimizes the release of circulating tumor cells compared to open surgery for hepatocellular carcinoma
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与肝细胞癌的开腹手术相比，腹腔镜手术可最大限度地减少循环肿瘤细胞的释放
DOI：
10.1007/s00464-014-4041-5
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发表时间：
2015-11-01
影响因子：
3.1
通讯作者：
Chen, Yajin
中科院分区：
文献类型：
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作者：
Li, Wenda;Zhou, Xue;Chen, Yajin
BackgroundThe本研究的目的是确定肿瘤操作是否增强了肝癌患者原发肿瘤的癌细胞释放，以及哪种手术方法，开放手术或腹腔镜切除术，对于防止肿瘤细胞在blood.MethodsA中分散，共26例肝癌患者前瞻性随机接受开放手术（n= 14）或腹腔镜手术（n= 12）。在三个时间点采集血样：术前、术后和术后24 h。获得CD 45 −/CD 44 +/CD 90+细胞，并使用定量流式细胞术进行计数。血清白细胞介素-6（IL-6），白细胞介素-8（IL-8），和肿瘤坏死因子（TNF-α）的水平也比较了两组之间。ResultsThere是腹腔镜和开放组之间的患者特征方面没有显着差异。CCSCs的水平在手术操作后立即增加，腹腔镜组释放到血流中的肿瘤细胞较少。两组中CCSC的量在手术后24 h下降至相似水平。术后IL-6和IL-8均升高，腹腔镜组IL-6和IL-8血清水平的平均术后升高显著低于开放组。TNF-α水平在任何时间点均无差异。ConclusionsOur结果表明，腹腔镜手术患者的IL-6，IL-8分泌量较低，CTCs较少，这可能表明通过限制CTCs释放和保留免疫反应的优势。需要进一步的研究来调查手术后CCSC数量与长期生存率之间的关系。
BackgroundThe aim of this study was to determine whether tumor manipulation enhances cancer cell release from the primary tumor in HCC patients and which surgical approach, open surgery or laparoscopic resection, is superior with respect to preventing tumor cells from scattering in the blood.MethodsA total of 26 HCC patients were prospectively randomized to receive either open surgery (n= 14) or laparoscopic surgery (n= 12). Blood samples were obtained at three time points: preoperative, postoperative, and 24 h after surgery. The CD45−/CD44+/CD90+cells were obtained and counted using quantitative flow cytometry. The serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF-α) were also compared between the two groups.ResultsThere was no significant difference between the laparoscopic and open groups in terms of patient characteristics. The levels of CCSCs increased immediately after surgical manipulation, and the laparoscopy group released fewer tumor cells into the blood stream. The amount of CCSCs in both groups decreased to reach a similar level 24 h after surgery. Both IL-6 and IL-8 increased after surgery, and the mean postoperative increases in IL-6 and IL-8 serum levels were significantly less in the laparoscopic group than in the open group. The TNF-α levels showed no differences at any time point.ConclusionsOur results showed that patients with laparoscopic surgery have lower IL-6, IL-8 secretion and less CTCs, which may suggest an advantage by restricting CTCs release and a preserved immune response. Further studies are needed to investigate the relationship between the number of CCSCs after surgery and long-term survival rates.