首页|血清血管内皮生长因子、胰岛素样生长因子-1水平与胸腔镜食管癌根治术后食管胃吻合口漏的相关性研究

血清血管内皮生长因子、胰岛素样生长因子-1水平与胸腔镜食管癌根治术后食管胃吻合口漏的相关性研究

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目的 探讨血清血管内皮生长因子(VEGF)、胰岛素样生长因子(IGF)-1水平与胸腔镜食管癌根治术后食管胃吻合口漏的关系.方法 2015年9月~2022年9月我院收治的食管癌病人425例,根据术后发生食管胃吻合口漏情况分为吻合口漏组(31例)和无吻合口漏组(394例).检测血清VEGF、IGF-1水平,分析影响胸腔镜食管癌根治术后食管胃吻合口漏发生的危险因素以及VEGF、IGF-1预测术后食管胃吻合口漏发生的价值.结果 吻合口漏组术后血清VEGF、IGF-1水平降低,无吻合口漏组血清VEGF、IGF-1水平增高,吻合口漏组术前、术后1天、术后2天、术后3天血清VEGF、IGF-1水平均低于无吻合口漏组,差异有统计学意义(P<0.05).术后肺部感染、低白蛋白、术后3天VEGF、术后3天IGF-1与术后食管胃吻合口漏有关(P<0.05).术后3天VEGF、术后3天IGF-1水平预测术后食管胃吻合口漏的曲线下面积为0.675、0.655,联合两项指标曲线下面积为0.841,高于单独指标(Delong z=3.752、3.218,P<0.05).结论 胸腔镜食管癌根治术后吻合口漏病人血清VEGF、IGF-1水平降低,且与吻合口漏的发生密切相关.
Study on the relationship between serum levels of vascular endothelial growth factor and insulin-like growth factor-1 and esophagogastric anastomotic fistula in patients after thoracoscopic radical resection of esophageal cancer
Objective To investigate the relationship between serum levels of vascular endothelial growth factor(VEGF)and insulin-like growth factor 1(IGF-1)and esophagogastric anastomotic fistula after thoracoscopic radical resection of esophageal cancer.Methods 425 patients with esophageal cancer treated in our hospital from September 2015 to September 2022 were selected and divided into anastomotic fistula group(31 cases)and non-anastomotic fistula group(394 cases)according to the postoperative esophagogastric anastomotic fistula.Serum VEGF and IGF-1 levels were detected to analyze the risk factors affecting the occurrence of esophagogastric anastomotic fistula after thoracoscopic esophageal cancer surgery and the value of VEGF and IGF-1 in predicting the occurrence of esophagogastric anastomotic fistula after thoracoscopic esophageal cancer surgery.Results The serum levels of VEGF and IGF-1 in anastomotic fistula group decreased gradually after operation,while the serum levels of VEGF and IGF-1 in non-anastomotic fistula group increased gradually.The levels of serum VEGF and IGF-1 before,1 day aft er,2 day after and 3 day after anastomotic fistula group were lower than those of the group without anastomotic fistula(P<0.05).Postoperative pulmonary infection,hypoalbumin,postoperative 3 d VEGF and postoperative 3 d IGF-1 were associated with esophagogastric anastomotic fistula after thoracoscopic esophageal cancer(P<0.05).Postoperative 3 d VEGF and postoperative 3 d IGF-1 predicted the area under the curve of esophagogastric anastomosis fistula after thoracoscopic surgery for esophageal cancer was 0.675 and 0.655,and the area under the curve of the combined two indexes was 0.841,which was higher than the single index(Delong z=3.752,3.218,P<0.05).Conclusion The serum levels of VEGF and IGF-1 decreased in patients with anastomotic fistula after thoracoscopic radical resection of esophageal cancer,which was closely related to the occurrence of anastomotic fistula.

esophageal cancerthoracoscopeesophagogastric anastomotic fistulavascular endothelial growth factorinsulin-like growth factor-1

黄晓媚、郭明、骆俊龙、包传恩、胡蒙

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361003 福建医科大学附属厦门弘爱医院胸外科

中国人民解放军陆军第七十三集团军医院胸外科

食管癌 胸腔镜 食管胃吻合口漏 血管内皮生长因子 胰岛素样生长因子-1

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(3)
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