全胸腔镜肺叶切除术对肺癌患者PI3K、Notch-1水平的影响

孙宏建

【摘要】 目的：探討全胸腔镜肺叶切除术对肺癌患者磷脂酰肌醇-3激酶（PI3K）、Notch信号通路-1（Notch-1）水平的影响。方法：选取2018年1月-2020年1月本院收治的96例肺癌患者为研究对象，将其随机分为观察组和对照组，各48例。对照组给予开放式手术治疗，观察组行全胸腔镜肺叶切除术治疗。比较两组手术相关指标、并发症发生情况、肿瘤标志物水平、PI3K、Notch-1水平、生存情况。结果：观察组手术时间、术后排气时间、开始下床活动时间、住院时间均短于对照组，术中出血量少于对照组，差异均有统计学意义（P<0.05）。观察组术后并发症发生率为8.33%，低于对照组的25.00%，差异有统计学意义（P<0.05）。术后，两组CYFRA21-1、NSE、LTA、PI3K、Notch-1水平均低于术前，且观察组CYFRA21-1、NSE、LTA、PI3K、Notch-1水平均低于对照组，差异均有统计学意义（P<0.05）。经过为期12个月的随访，观察组PFS、OS均长于对照组，差异均有统计学意义（P<0.05）。结论：全胸腔镜肺叶切除术能提高肺癌患者的手术效果，降低患者的手术损伤，提高手术安全性，降低肿瘤标志物水平和PI3K、Notch-1水平，一定程度上延长患者的生存周期，可在临床实践中推广应用。

【关键词】 肺癌患者 全胸腔镜肺叶切除术 磷脂酰肌醇-3激酶 Notch信号通路-1

Effect of Total Thoracoscopic Lobectomy on the Levels of PI3K and Notch-1 in Patients with Lung Cancer/SUN Hongjian. //Medical Innovation of China， 2021， 18（30）： 0-024

[Abstract] Objective： To investigate the effects of total thoracoscopic lobectomy on the levels of phosphatidylinositol-3 kinase （PI3K） and Notch signaling pathway-1 （Notch-1） in patients with lung cancer. Method： A total of 96 lung cancer patients admitted to our hospital from January 2018 to January 2020 were selected as the research objects， and they were randomly divided into observation group and control group， 48 cases in each group. The control group was treated with open surgery， the observation group was treated with thoracoscopic lobectomy. The surgery related indicators， incidence of complications， tumor marker levels， PI3K， Notch-1 levels and survival situation were compared between the two groups. Result： The observation group had shorter surgery time， postoperative exhaust time， time to get out of bed and hospital stay than those in the control group， and the intraoperative blood loss was less than that of the control group， the differences were statistically significant （P<0.05）. The incidence of postoperative complications in the observation group was 8.33%， lower than 25.00% in the control group， the difference was statistically significant （P<0.05）. After surgery， the levels of CYFRA21-1， NSE， LTA， PI3K and Notch-1 in the two groups were lower than those before surgery， and the levels of CYFRA21-1， NSE， LTA， PI3K and Notch-1 in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. After 12 months of follow-up， PFS and OS in the observation group were longer than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Total thoracoscopic lobectomy can improve the surgical effect of lung cancer patients， reduce the surgical injury of patients， improve the safety of surgery， reduce the level of tumor markers and PI3K， Notch-1， and prolong the survival cycle of patients to a certain extent， which can be popularized and applied in clinical practice.

[Key words] Lung cancer patients Total thoracoscopic lobectomy Phosphatidylinositol-3 kinase Notch signaling pathway-1

First-authors address： Jiamusi Central Hospital， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.30.005

肺癌是危害性最大的恶性肿瘤疾病之一，在临床上有较高的发生率。近些年随着社会工作压力的增加、不良生活习惯的形成以及所处空气环境的恶化，肺癌的发生率有逐年升高的趋势，是对人类生命安全威胁最大的临床恶性肿瘤疾病[1-2]。对于早期确诊未出现癌细胞转移扩散的肺癌患者，手术是最为有效的治疗方案。常规的肺癌根治术主要以开腹手术结合淋巴结清扫，但常规开放式手术损伤性和创伤性较大，且多数肺癌患者均为中老年患者人群，对于这种开放式手术的创伤性难以耐受[3-4]。随着微创技术和相关器械的发展进步，微创手术在各类外科手术治疗中的应用不断增多。全胸腔镜肺叶切除术是一种新型的安全性较高的微创外科手术，具有微创手术典型的创伤性小、失血量少及术后康复快的优势，在早期的肺癌病灶根治性切除中有良好的应用价值[5-6]。……