模擬CO2氣腹對小鼠胃癌腹腔巨噬細胞功能的影響_《中國普外基礎與臨床雜志》

作者：

羅華星 , 余佩武 , 郝迎學 , 趙永亮 , 石彥 , 唐波

第三軍醫大學西南醫院全軍普通外科中心，微創胃腸外科中心(重慶400038);

關鍵詞：

腹腔鏡胃癌 CO2氣腹腹腔巨噬細胞腹腔種植

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目的探討模擬不同壓力CO2氣腹環境下小鼠胃癌腹腔巨噬細胞功能變化以及對胃癌腹腔種植轉移的影響。方法建立小鼠前胃癌615小鼠原位種植模型，將其隨機分為5組，每組30只: 單純麻醉組、開腹組以及2、4和6 mm Hg (1 mm Hg=0.133 kPa) CO2氣腹組。術后每組各取6只小鼠收集培養腹膜巨噬細胞，培養12、24、48和72 h，檢測巨噬細胞吞噬功能及NO和TNFα水平。其余小鼠術后2周時觀察小鼠前胃癌細胞腹腔種植轉移率及種植結節的總重量。結果各組小鼠術后均無死亡，無腹水產生，各組小鼠平均體重的差異無統計學意義(P gt;0.05)。在培養12 h時，開腹組小鼠術后腹腔巨噬細胞吞噬中性紅值、NO和TNF-α水平均明顯高于其他4組(P lt;0.05)，而單純麻醉組小鼠又明顯高于2、4和6 mm Hg CO2氣腹組(P lt;0.05); 2 mm Hg CO2氣腹組明顯高于4和6 mm Hg CO2氣腹組(P lt;0.05)，而4 mm Hg和6 mm Hg CO2氣腹組間比較差異無統計學意義(P gt;0.05)。在培養24 h時，6 mm Hg CO2氣腹組小鼠術后腹腔巨噬細胞吞噬中性紅值、NO和TNF-α水平均明顯低于其他4組(P lt;0.05)，其他4組間比較差異無統計學意義(P gt;0.05)。在培養48 h和72 h時，各組小鼠術后腹腔巨噬細胞吞噬中性紅值、NO和TNF-α水平比較差異均無統計學意義(P gt;0.05)。單純麻醉組、開腹組以及2、4 和6 mm Hg CO2氣腹組小鼠前胃癌腹腔種植轉移率為分別為100%(24/24)、50.0%(10/20)、47.8%(11/23)、45.5%(10/22)和75.0%(15/20)，組間比較6 mm Hg CO2氣腹組明顯低于單純麻醉組(P lt;0.05)而高于其他3組(P lt;0.05)，其他3組間兩兩比較差異均無統計學意義(P gt;0.05)。單純麻醉組、開腹組以及2、4和6 mm Hg CO2氣腹組小鼠前胃癌腹腔種植結節重量分別為(1.24±0.48) g、(1.02±0.38) g、(0.96±0.33) g、(0.93±0.45) g和(1.18±0.37) g，各組間比較差異均無統計學意義(P gt;0.05)。結論高壓力(6 mm Hg) CO2氣腹可較長時間抑制胃癌小鼠腹腔巨噬細胞的吞噬與分泌功能，促進胃癌的腹腔種植轉移。

引用本文： 羅華星,余佩武,郝迎學,趙永亮,石彥,唐波. 模擬CO2氣腹對小鼠胃癌腹腔巨噬細胞功能的影響. 中國普外基礎與臨床雜志, 2011, 18(2): 116-121. doi: 復制

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7.	郝迎學, 鐘華, 曾冬竹, 等. 不同壓力二氧化碳氣腹對胃癌細胞增殖運動的影響 [J]. 中華消化外科雜志, 2008, 7(1): 5658.
8.	郝迎學, 鐘華, 張超, 等. 不同壓力二氧化碳氣腹對胃癌細胞遷移運動和細胞骨架的影響 [J]. 中華胃腸外科雜志, 2008, 11(5): 454457.
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10.	Gitzelmann CA, MendozaSagaon M, Talamini MA, et al. Cellmediated immune response is better preserved by laparoscopy than laparotomy [J]. Surgery, 2000, 127(1): 6571.
11.	Aoyagi K, Kouhuji K, Yano S, et al. VEGF significance in peritoneal recurrence from gastric cancer [J]. Gastric Cancer, 2005, 8(3): 155163.
12.	Kumagai K, Shimizu K, Yokoyama N, et al. Gastrointestinal cancer metastasis and lymphatic advancement [J]. Surg Today, 2010, 40(4): 301306.
13.	余佩武, 郝迎學. CO2氣腹對胃腸道腫瘤侵襲轉移影響的研究現狀與進展 [J]. 中國普外基礎與臨床雜志, 2009, 16(10): 777780.
14.	劉驊, 周敏, 趙文毅, 等. 不同壓強與時程CO2氣腹對胃癌細胞黏附侵襲能力的影響 [J]. 中國普外基礎與臨床雜志, 2010, 17(6): 557561.
15.	Nakada H, Ishida H, Hashimoto D, et al. Influence of different pneumoperitoneal pressures on tumor cell distribution rats [J]. Surg Endosc, 2005, 19(4): 563568.
16.	Tang CL, Eu KW, TaiBC, et al. Randomized clinical trail of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer [J]. Br J Surg, 2001, 88(6): 801807.
17.	Wichmann MW, Hüttl TP, Winter H, et al. Immunological effects of laparoscopic vs open colorectal surgery: a prospective clinical study [J]. Arch Surg, 2005, 140(7): 692697.
18.	Are C, Talamini MA. Laparoscopy and malignancy [J]. J Laparoendosc Adv Surg Tech A, 2005, 15(1): 3847.
19.	Nakamura T, Mitomi H, Ohtani Y, et al. Comparison of longterm outcome of laparoscopic and conventional surgery for advanced colon and rectosigmoid cancer [J]. Hepatogastroenterology, 2006, 53(69): 351353.
20.	Ost MC, Tan BJ, Lee BR. Urological　laparoscopy:　basic physiological considerations and immunological consequences [J]. J Urol, 2005, 174(4 Pt 1): 11831188.
21.	Ure BM, Niewold TA, Bax NM, et al. Peritoneal, systemic, and distant organ inflammatory responses are reduced by a laparoscopic approach and carbon dioxide versus air [J]. Surg Endosc, 2002, 16(5): 836842.
22.	Moehrlen U, Ziegler U, Boneberg E, et al. Impact of carbon dioxide versus air pneumoperitoneum on peritoneal cell migration and cell fate [J]. Surg Endosc, 2006, 20(10): 16071613.
23.	Hajri A, Mutter D, Wack S, et al. Dual effect of laparoscopy on cellmediated immunity [J]. Eur Surg Res, 2000, 32(5): 261266.
24.	Buunen M, Gholghesaei M, Veldkamp R, et al. Stress response to laparoscopic surgery: a review [J]. Surg Endosc, 2004, 18(7): 10221028.
25.	Kuebler JF, Kos M, Jesch NK, et al. Carbon dioxide suppresses macrophage superoxide anion production independent of extracellular pH and mitochondrial activity [J]. J Pediatr Surg, 2007, 42(1): 244248.
26.	Grabowski JE, Vega VL, Talamini MA, et al. Acidification enhances peritoneal macrophage phagocytic activity [J]. J Surg Res, 2008, 147(2): 206211.

1. Kitano S, Iso Y, Moriyama M, et al. Laparoscopyassisted Billroth Ⅰ gastrectomy [J]. Surg Laparosc Endosc, 1994, 4(2): 146148.
2. Kitano S, Shiraishi N, Uyama I, et al. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan [J]. Ann Surg, 2007, 245(1): 6872.
3. Park JM, Jin SH, Lee SR, et al. Complications with laparoscopically assisted gastrectomy: multivariate analysis of 300 consecutive cases [J]. Surg Endosc, 2008, 22(10): 21332139.
4. 余佩武, 王自強, 錢鋒, 等. 腹腔鏡輔助胃癌根治術105例 [J]. 中華外科雜志, 2006, 44(19): 13031306.
5. 余佩武, 錢鋒, 羅華星, 等. 腹腔鏡胃癌根治術的臨床療效 [J]. 中華消化外科雜志, 2008, 7(1): 3840.
6. Hao YX, Zhong H, Zhang C, et al. Effects of simulated carbon dioxide and helium peumoperitoneum on proliferation and apoptosis of gastric cancer cells [J]. World J Gastroenterol, 2008, 14(14): 22412245.
7. 郝迎學, 鐘華, 曾冬竹, 等. 不同壓力二氧化碳氣腹對胃癌細胞增殖運動的影響 [J]. 中華消化外科雜志, 2008, 7(1): 5658.
8. 郝迎學, 鐘華, 張超, 等. 不同壓力二氧化碳氣腹對胃癌細胞遷移運動和細胞骨架的影響 [J]. 中華胃腸外科雜志, 2008, 11(5): 454457.
9. Whelan RL, Franklin M, Holubar SD, et al. Postoperative cellmediated immune response is better preserved after laparoscopic vs open colorectal resection in humans [J]. Surg Endosc, 2003, 17(6): 972978.
10. Gitzelmann CA, MendozaSagaon M, Talamini MA, et al. Cellmediated immune response is better preserved by laparoscopy than laparotomy [J]. Surgery, 2000, 127(1): 6571.
11. Aoyagi K, Kouhuji K, Yano S, et al. VEGF significance in peritoneal recurrence from gastric cancer [J]. Gastric Cancer, 2005, 8(3): 155163.
12. Kumagai K, Shimizu K, Yokoyama N, et al. Gastrointestinal cancer metastasis and lymphatic advancement [J]. Surg Today, 2010, 40(4): 301306.
13. 余佩武, 郝迎學. CO2氣腹對胃腸道腫瘤侵襲轉移影響的研究現狀與進展 [J]. 中國普外基礎與臨床雜志, 2009, 16(10): 777780.
14. 劉驊, 周敏, 趙文毅, 等. 不同壓強與時程CO2氣腹對胃癌細胞黏附侵襲能力的影響 [J]. 中國普外基礎與臨床雜志, 2010, 17(6): 557561.
15. Nakada H, Ishida H, Hashimoto D, et al. Influence of different pneumoperitoneal pressures on tumor cell distribution rats [J]. Surg Endosc, 2005, 19(4): 563568.
16. Tang CL, Eu KW, TaiBC, et al. Randomized clinical trail of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer [J]. Br J Surg, 2001, 88(6): 801807.
17. Wichmann MW, Hüttl TP, Winter H, et al. Immunological effects of laparoscopic vs open colorectal surgery: a prospective clinical study [J]. Arch Surg, 2005, 140(7): 692697.
18. Are C, Talamini MA. Laparoscopy and malignancy [J]. J Laparoendosc Adv Surg Tech A, 2005, 15(1): 3847.
19. Nakamura T, Mitomi H, Ohtani Y, et al. Comparison of longterm outcome of laparoscopic and conventional surgery for advanced colon and rectosigmoid cancer [J]. Hepatogastroenterology, 2006, 53(69): 351353.
20. Ost MC, Tan BJ, Lee BR. Urological　laparoscopy:　basic physiological considerations and immunological consequences [J]. J Urol, 2005, 174(4 Pt 1): 11831188.
21. Ure BM, Niewold TA, Bax NM, et al. Peritoneal, systemic, and distant organ inflammatory responses are reduced by a laparoscopic approach and carbon dioxide versus air [J]. Surg Endosc, 2002, 16(5): 836842.
22. Moehrlen U, Ziegler U, Boneberg E, et al. Impact of carbon dioxide versus air pneumoperitoneum on peritoneal cell migration and cell fate [J]. Surg Endosc, 2006, 20(10): 16071613.
23. Hajri A, Mutter D, Wack S, et al. Dual effect of laparoscopy on cellmediated immunity [J]. Eur Surg Res, 2000, 32(5): 261266.
24. Buunen M, Gholghesaei M, Veldkamp R, et al. Stress response to laparoscopic surgery: a review [J]. Surg Endosc, 2004, 18(7): 10221028.
25. Kuebler JF, Kos M, Jesch NK, et al. Carbon dioxide suppresses macrophage superoxide anion production independent of extracellular pH and mitochondrial activity [J]. J Pediatr Surg, 2007, 42(1): 244248.
26. Grabowski JE, Vega VL, Talamini MA, et al. Acidification enhances peritoneal macrophage phagocytic activity [J]. J Surg Res, 2008, 147(2): 206211.

《中國普外基礎與臨床雜志》

模擬CO2氣腹對小鼠胃癌腹腔巨噬細胞功能的影響

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《中國普外基礎與臨床雜志》

模擬CO2氣腹對小鼠胃癌腹腔巨噬細胞功能的影響

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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