不同手术方式治疗喉癌的远期疗效及其手术切缘组织中p53和c-myc蛋白的水平

发布时间：2018-06-03 09:13

本文选题：全喉切除术 + 喉部分切除术　；参考：《中国现代医学杂志》2017年24期

【摘要】：目的探讨不同手术方式治疗喉癌的远期疗效及其手术切缘组织中p53和c-myc蛋白的表达水平。方法选取2007年12月-2011年12月在该院接受治疗的74例喉癌患者作为研究对象,根据患者意愿将其分为对照组和观察组,每组各37例,对照组给予全喉切除术治疗,观察组给予喉部分切除术治疗,对比分析两组患者术后血液炎症指标、手术切缘组织中p53和c-myc蛋白水平、喉功能恢复情况和并发症发生率、复发率、生存率及生活质量。结果术后7 d,对照组患者IL-6和CRP水平均高于观察组(P0.05);两组患者术后3和5年存活率比较,差异无统计学意义(P0.05);观察组患者随访期间复发率为21.62%,高于对照组5.41%(P0.05);观察组患者手术切缘组织中p53蛋白阳性率为51.35%,高于对照组27.03%(P0.05);复发患者手术切缘组织中p53蛋白阳性率高于未复发患者(P0.05);c-myc蛋白阳性率在复发和未复发患者间以及观察组和对照组间,差异无统计学意义(P0.05);两组并发症发生率比较,差异无统计学意义(P0.05);观察组患者术后喉功能恢复情况优于对照组(P0.05);观察组患者娱乐、交流、吞咽、咀嚼及生活质量总得分均高于对照组(P0.05)。结论与全喉切除术比较,喉部分切除术复发率较高,但对喉功能影响较小,且患者术后生活质量较高,手术切缘组织中p53蛋白阳性检测对患者术后复发预测具有重要意义。
[Abstract]:Objective to investigate the long term effect of different surgical methods for laryngeal carcinoma and the expression of p53 and c-myc protein in surgical margin. Methods from December 2007 to December 2011, 74 patients with laryngeal cancer were divided into control group and observation group according to the wishes of the patients. The control group was treated with total laryngectomy, and the control group was treated with total laryngectomy. The patients in the observation group were treated with partial laryngectomy. The indexes of blood inflammation, the levels of p53 and c-myc protein, the recovery of laryngeal function and the incidence of complications, recurrence rate, survival rate and quality of life were compared between the two groups. Results on the 7th day after operation, the levels of IL-6 and CRP in the control group were higher than those in the observation group (P 0.05), and the survival rates of the two groups were 3 and 5 years after operation. The recurrence rate of the patients in the observation group was 21.62, which was higher than that in the control group (5.41), the positive rate of p53 protein in the surgical margin of the observation group was 51.35, which was higher than that in the control group (27.03g / P 0.05), and the positive rate of p53 protein positive in the tissue of the surgical margin of the patients with recurrence was higher than that of the control group. The positive rate of c-myc protein was higher in patients without recurrence than that in patients without recurrence, and the positive rate of c-myc protein was higher in patients without recurrence than in patients without recurrence, and between the observation group and the control group. There was no significant difference in the incidence of complications between the two groups (P 0.05). The recovery of laryngeal function in the observation group was better than that in the control group (P 0.05). The total score of mastication and quality of life was higher than that of control group (P 0.05). Conclusion compared with total laryngectomy, the recurrence rate of partial laryngectomy is higher, but the effect on laryngeal function is less, and the quality of life is higher. The positive detection of p53 protein in surgical margin is of great significance in predicting postoperative recurrence.
【作者单位】：江苏省常州市第一人民医院;
【分类号】：R739.65

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