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腹腔镜手术联合护理干预对子宫颈癌细胞凋亡率的影响及相关机制研究
作者:曾祖华  陈朝霞  潘彧 
单位:川北医学院附属医院 妇产科, 四川 南充 637000
关键词:腹腔镜 广泛子宫全切 盆腔淋巴结清扫术 子宫颈癌细胞 凋亡率 
分类号:R713.4
出版年·卷·期(页码):2018·46·第二期(176-180)
摘要:

目的:分析腹腔镜下广泛子宫全切加盆腔淋巴结清扫术对子宫颈癌细胞凋亡率的影响及其相关机制。方法:选取本院2013年3月~2015年3月收治的80例老年子宫颈癌患者及40例子宫肌瘤患者作为研究对象。80例子宫颈癌患者,40例进行腹腔镜下广泛子宫全切加盆腔淋巴结清扫术,40例进行开腹广泛子宫全切加盆腔淋巴结清扫术。40例子宫肌瘤患者行腹腔镜全子宫切除术。采用流式细胞分析分别测定40例宫颈癌腹腔镜手术患者,手术前、后子宫颈癌细胞的凋亡率,并观察Trai L、Bcl-2、MTA1和NM23基因的表达水平,将其与腹腔镜下子宫全切术的正常子宫颈细胞和开腹手术的子宫颈癌细胞的手术前、后进行比较。结果:子宫颈癌细胞的术前凋亡率是(4.25±0.17)%,腹腔镜术后的凋亡率是(26.54±0.64)%,明显高于术前,经统计分析,具有显著性差异(P<0.05);开腹手术后的凋亡率是(5.08±0.28)%,与术前相比,经统计分析,不具有显著性差异(P>0.05);子宫肌瘤患者术前的子宫颈细胞凋亡率是(18.26±0.46)%,腹腔镜术后的凋亡率是(17.36±0.57)%。行腹腔镜手术后的子宫颈癌细胞的抑制转移基因NM23和诱导凋亡基因Trail的表达水平明显比术前高,而相关转移基因M TA1和抑制凋亡基因Bcl-2的表达水平则明显比术前低;正常的子宫颈细胞其相关基因Bcl-2、MTA1、Trail和NM23的表达水平不受腹腔镜手术对机体的环境造成的变化而发生改变。结论:采用腹腔镜手术治疗子宫颈癌不会增加癌细胞的增殖能力与转移能力,具有较好的临床有效性和安全性。

Objective: To analyze the influence of laparoscopic hysterectomyand pelvic lymphadenectomy combined with nursing intervention on cervical cancer cell apoptosis rate and its related mechanism. Methods: 80 examples of cervical cancer patients in the hospital from March 2013 to March 2015 were chosen as the research objects, 40received laparoscopic hysterrectomy and lymphadenectomy, and 40 were performed total laparoscopic hysterectomy, Using flow cytometrycervical cancer cell apoptosis rate was determined before and after the surgery, Trai L, Bcl-2, MTA1 and NM23 gene expression level were observed, cervical cancer cells before and after laparoscopy and laparotomywere compared. Results: The preoperative apoptosis rate for cervical cancer cells was(4.25±0.17)%, apoptosis rate for laparoscopic surgery was(26.54±0.64)%, significantly higher than that of preoperative, through statistical analysis, with a significant difference(P<0.05);After open operation, the apoptosis rate was(5.08±0.28)%, compared with the preoperative, it did not have significant difference(P>0.05); Patients with hysteromyoma cervical cell apoptosis rate was(18.26±0.46)%, apoptosis rate for laparoscopic surgery was(17.36±0.57)%. The expression of NM23 and Trail in cervical cancer cells after laparoscopic surgery was significantly higher than that before operation. The expression levels of M TA1 and Bcl-2 were significantly lower than those before operation. The expression levels of Bcl-2 MTA1 Trail and NM23 in normal cervical cells were not changed by the changes of the environment caused by laparoscopic surgery. Conclusion: The use of laparoscopic surgery for cervical cancer does not increase the proliferation and metastasis of cancer cells, and it has good clinical efficacy and safety.

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