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目的研究黏附分子在CO2气腹腹腔镜手术腹膜中的表达,借以探讨黏附分子与腹腔内恶性肿瘤种植转移的关系。方法选取120例子宫肌瘤或单纯卵巢囊肿(排除腹膜炎症)随机进行开腹手术和腹腔镜手术,分别于进腹和充气后0 h、1 h以及2 h采集壁层腹膜,采用免疫组化方法检测黏附分子(ICAM-1、VCAM-1)在腹膜中的阳性表达率。结果 ICAM-1、VCAM-1在正常状态下低水平表达;不论腹腔镜组还是开腹组,两者的阳性表达率都随着手术时间延长而增加,且差异显著(P<0.01);两组比较,ICAM-1的阳性率差异显著(P<0.05),腹腔镜组表达率高于开腹组。VCAM-1阳性率两组差异不显著(P>0.05)。结论 CO2气腹腹腔镜组ICAM-1的表达高于开腹组,这与腹腔镜下腹腔恶性肿瘤的转移率高相符,说明黏附分子在此过程中可能起一定作用。
Objective To study the expression of adhesion molecules in the peritoneum of CO2 pneumoperitoneum laparoscopy in order to investigate the relationship between the adhesion molecules and the metastasis of intraperitoneal malignant tumors. Methods 120 cases of uterine fibroids or simple ovarian cysts (excluding peritoneal inflammation) were randomly divided into laparotomy and laparoscopic surgery. The parietal peritoneum was collected at 0 h, 1 h and 2 h after infiltration and inflation, respectively. Immunohistochemistry Methods The positive rate of adhesion molecules (ICAM-1, VCAM-1) in peritoneum was detected. Results The expression of ICAM-1 and VCAM-1 was low in normal condition. The positive expression rates of ICAM-1 and VCAM-1 in both laparoscopic group and laparotomy group increased with the operation time prolonging (P <0.01) The positive rate of ICAM-1 was significantly different between groups (P <0.05). The expression rate of laparoscopic group was higher than that of laparotomy group. The positive rate of VCAM-1 was not significantly different between the two groups (P> 0.05). Conclusion The expression of ICAM-1 in pneumoperitoneum group is higher than that in laparotomy group, which is consistent with the high metastatic rate of laparoscopic abdominal malignant tumor, indicating that adhesion molecule may play a role in this process.