1.Short-term efficacy of thoracoscopic radical surgery for esophageal cancer and its effect on lung function and tissue expression of tissue myeloid cell trigger receptor-1and tumor necrosis factor receptor-related protein 1
Haifeng WANG ; Guangliang QIANG ; Boheng XIE ; Dongbin YANG ; Huanwang DU
Chinese Journal of Postgraduates of Medicine 2021;44(4):322-327
Objective:To investigate the short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer and its influence on the expression of trigger receptor-1 (TRE-1) and tumor necrosis factor receptor-associated protein 1 (TRAP1).Methods:A total of 68 patients with esophageal cancer who were admitted to First People′s Hospital of Ningyang from June 2016 to June 2019 were selected and divided into thoracoscope radical surgery group and raditional surgery group by stratified sampling method, with 34 cases in each group. The thoracoscopic radical surgery group was treated with thoracoscopic radical surgery, and the traditional surgery group was treated with traditional open radical esophageal cancer surgery with neck, chest, and abdominal incisions. The levels of inflammatory factors, immune function, lung function indexes, TREM-1, TRAP1 expression and complications of the two groups were observed and compared.Results:Before operation, the levels of inflammatory factors tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10 in two groups had no significant differences ( P>0.05). At 2 d after operation, the levels of TNF-α, IL-6, IL-10 in two groups were increased and the levels of above index in the thoracoscopic radical surgery group were lower than those in the traditional surgery group: (23.21 ± 0.32) mg/L vs. (29.69 ± 0.48) mg/L, (232.15 ± 23.64) ng/L vs. (246.73 ± 25.89) ng/L, (0.64 ± 0.19) ng/L vs. (0.89 ± 0.21) ng/L, and there were statistical differences ( P<0.05). Before operation, the levels of CD 3+, CD 4+, CD 8+, and CD 4+/CD 8+ in two groups had no significant differences ( P>0.05). At 2 d after operation, the levels of CD 3+, CD 4+, CD 8+ decreased and the level of CD 4+/CD 8+ increased, and the levels of CD 3+, CD 4+, CD 8+, CD 4+/CD 8+ in the thoracoscopic radical surgery group were higher than those in the traditional surgery group: (46.78 ± 1a2.43)% vs. (41.32 ± 9.36)%, (46.12 ± 9.68)% vs. (41.59 ± 7.98)%, (27.42 ± 4.27)% vs. (21.38 ± 3.16)%, 1.47 ± 0.46 vs. 1.25 ± 0.27, and there were statistical differences ( P<0.05). Before operation, the levels of forced expiratory volume in one second (FEV 1), forced vital capacity (FVC), FEV 1/FVC in two groups had no significant differences ( P>0.05). At 2 day after operation, the levels of FEV 1, FVC, FEV 1/FVC in two groups decreased, and the levels of FEV 1, FVC, FEV 1/FVC in the thoracoscopic radical surgery group were higher than those in the traditional surgery group: (2.37 ± 0.72) L vs. (1.82 ± 0.53) L, (3.34 ± 1.06) L vs. (2.43 ± 0.82) L, (62.47 ± 15.26)% vs. (53.67 ± 12.28)%, and there were statistical differences ( P<0.05).Before operation, the expression of TREM-1 and TRAP1 in two groups had no significant differences ( P>0.05). At 2 d after operation, the expression of TREM-1in the thoracoscopic radical surgery group was higher than that of traditional surgery group: (141.56 ± 34.69 vs. 121.54 ± 22.75); the expression of TRAP1 was lower than that of the traditional surgery group: (1.63 ± 0.51 vs. 2.11 ± 0.64), and there were statistical differences ( P<0.05). The postoperative complication rate of the thoracoscopic radical surgery group was lower than that of the traditional surgery group:5.88%(2/34) vs. 23.53%(8/34), and there was statistical difference ( χ2=4.221, P=0.040). Conclusions:The short-term efficacy of thoracoscopic radical surgery in the treatment of esophageal cancer is better than that of the traditional surgery group, which can increase the expression of TREM-1, reduce the expression of TRAP1, and reduce the inflammatory response and the impact on the immune function.