劉驊 1 , 周敏 2 , 趙文毅 1 , 曹暉 1
  • 1.上海交通大學(xué)醫(yī)學(xué)院附屬仁濟醫(yī)院普外科（上海 200127）;;
  • 2. 浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院普外科（浙江 310003）;

目的  分析不同壓強與時程的CO2氣腹對胃癌細胞黏附侵襲能力的影響。方法  建立體外CO2氣腹模型，選用3種胃癌細胞株MKN-45、SGC-7901和MKN-28，分別暴露在0 mm Hg（1 mm Hg=0.133 kPa）、9 mm Hg （2 h、4 h）和 15 mm Hg（2 h、4 h）的條件下。RT-PCR法檢測胃癌細胞中黏附侵襲分子E-cadherin、細胞間黏附分子-1（ICAM-1）、金屬基質(zhì)蛋白酶-2（MMP-2）和血管內(nèi)皮生長因子-A（VEGF-A） mRNA在上述條件下的表達水平； 流式細胞儀檢測胃癌細胞中E-cadherin和ICAM-1蛋白在0 mm Hg和15 mm Hg（4 h）條件下的表達水平。結(jié)果  隨著CO2時程延長或壓強升高，E-cadherin mRNA的表達水平有下降趨勢，而ICAM-1、MMP-2和VEGF-A mRNA的表達水平則有上升趨勢； 流式細胞儀檢測結(jié)果顯示E-cadherin蛋白的表達水平有下降趨勢，而ICAM-1蛋白的表達水平有升高的趨勢。但各種條件下黏附侵襲分子的表達水平比較，差異均無統(tǒng)計學(xué)意義(P＞0.05)。結(jié)論  在壓強不高于15 mm Hg和時程不超過4 h前提下，不同壓強與時程的CO2氣腹對胃癌細胞株的黏附侵襲能力無明顯影響，并不增加腫瘤的轉(zhuǎn)移幾率。

引用本文： 劉驊,周敏,趙文毅,曹暉. 不同壓強與時程CO2氣腹對胃癌細胞黏附侵襲能力的影響. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(6): 557-561. doi: 復(fù)制

1. Metzelder M, Kuebler JF, Shimotakahara A, et al. CO2 pneumoperitoneum increases survival in mice with polymicrobial peritonitis [J]. Eur J Pediatr Surg， 2008; 18(3): 171-175.
2. 余佩武， 郝迎學(xué). CO2氣腹對胃腸道腫瘤侵襲轉(zhuǎn)移影響的研究現(xiàn)狀與進展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2009; 16(10): 777-780.
3. Memon MA, Khan S, Yunus RM, et al. Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma [J]. Surg Endosc, 2008; 22(8): 1781-1789.
4. Topal B, Leys E, Ectors N, et al. Determinants of complications and adequacy of surgical resection in laparoscopic versus open total gastrectomy for adenocarcinoma [J]. Surg Endosc, 2008; 22(4): 980-984.
5. Person B, Cera SM. Prolonged postlaparoscopy carbon dioxide pneumoperitoneum [J]. Surg Laparosc Endosc Percutan Tech, 2008; 18(1): 114-117.
6. Fuganti PE, Rodrigues Júnior AJ, Rodrigues CJ, et al. A comparison of the effects of pneumoperitoneum and laparotomy on natural killer cell mediated cytotoxicity and Walker tumor growth in Wistar rats [J]. Surg Endosc, 2006; 20(12): 1858-1861.
7. Kosugi C, Ono M, Saito N, et al. Port site recurrence diagnosed by positron emission tomography after laparoscopic surgery for colon cancer [J]. Hepatogastroenterology, 2005; 52(65): 1440-1443.
8. Hirabayashi Y, Yamaguchi K, Shiraishi N, et al. Port-site metastasis after CO2 pneumoperitoneum: role of adhesion molecules and prevention with antiadhesion molecules [J]. Surg Endosc, 2004; 18(7): 1113-1117.
9. 田永剛， 許軍， 代文杰， 等. 人工氣腹對結(jié)腸癌細胞增殖影響的實驗研究 [J]. 中華普通外科雜志, 2007; 22(8): 623-626.
10. 馬君俊， 馮波， 張軼， 等. CO2氣腹對結(jié)腸癌細胞侵襲能力影響的體外研究 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(5): 512-515.
11. 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.
12. Tan BJ, Dy JS, Chiu PY, et al. Effects of pneumoperitoneal gases and pressures on transitional cell carcinoma adhesion, growth, apoptosis and necrosis: an in vitro study [J]. J Urol, 2005; 174(4 Pt 1): 1463-1467.
13. Peng Y, Zheng M, Feng B, et al. Hyperthermic CO2 pneumoperitoneum induces apoptosis in human colon cancer cells through Bax-associated mitochondrial pathway [J]. Oncol Rep, 2008; 19(1): 73-79.
14. 王廣義， 孟憲瑛， 顧建華， 等. CO2氣腹對腫瘤細胞種植與生長的影響 [J]. 中國普外基礎(chǔ)與臨床雜志, 2004; 11(2): 133-135.
15. Ordemann J, Hflich C, Braumann C, et al. Impact of pneumoperitoneum on expression of E-cadherin, CD44v6 and CD54 (ICAM-1) on HT-29 colon-carcinoma cells [J]. Zentralbl Chir, 2005; 130(5): 405-409.
16. Yavuz Y, Rnning K, Lyng O, et al. Effect of carbon dioxide pneumoperitoneum on tissue blood flow in the peritoneum, rectus abdominis, and diaphragm muscles [J]. Surg Endosc, 2003; 17(10): 1632-1635.
17. Schmidt AI, Reismann M, Kübler JF, et al. Exposure to carbon dioxide and helium reduces in vitro proliferation of pediatric tumor cells [J]. Pediatr Surg Int, 2006; 22(1): 72-77.
18. Ishida H, Hashimoto D, Nakada H, et al. Increased insufflation pressure enhances the development of liver metastasis in a mouse laparoscopy model: possible mechanisms [J]. Surg Endosc, 2002; 16(2): 331-335.
19. 張浩波， 王灝， 鄭民華. 持續(xù)性CO2氣腹影響腹腔鏡手術(shù)切口腫瘤細胞種植的實驗研究 [J]. 中國普外基礎(chǔ)與臨床雜志, 2002; 9(1): 16-18.
20. 石彥， 郝迎學(xué)， 雷曉， 等. 模擬CO2氣腹對人胃癌MKN-45細胞增殖和細胞周期的影響 [J]. 第三軍醫(yī)大學(xué)學(xué)報, 2007; 29(23): 2274-2276.
21. Tosun M, Samli H, Arikan Y, et al. The effects of CO2 pneumoperitoneum on the apoptotic index in the peritoneum [J]. Adv Ther, 2007; 24(4): 883-889.
22. Nesek-Adam V, Mrsic＇ V, Smiljanic＇ A, et al. Pathophysiologic effects of CO2-pneumoperitoneum in laparoscopic surgery [J]. Acta Med Croatica, 2007; 61(2): 165-170.
23. Wildbrett P, Oh A, Naundorf D, et al. Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function [J]. Surg Endosc, 2003; 17(1): 78-82.
24. Kim ZG, Mehl C, Lorenz M, et al. Impact of laparoscopic CO2-insufflation on tumor-associated molecules in cultured colorectal cancer cells [J]. Surg Endosc, 2002; 16(8): 1182-1186.
25. Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [J]. Dis Colon Rectum, 2005; 48(12): 2217-2223.
26. 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.
  1. 1. Metzelder M, Kuebler JF, Shimotakahara A, et al. CO2 pneumoperitoneum increases survival in mice with polymicrobial peritonitis [J]. Eur J Pediatr Surg， 2008; 18(3): 171-175.
  2. 2. 余佩武， 郝迎學(xué). CO2氣腹對胃腸道腫瘤侵襲轉(zhuǎn)移影響的研究現(xiàn)狀與進展 [J]. 中國普外基礎(chǔ)與臨床雜志, 2009; 16(10): 777-780.
  3. 3. Memon MA, Khan S, Yunus RM, et al. Meta-analysis of laparoscopic and open distal gastrectomy for gastric carcinoma [J]. Surg Endosc, 2008; 22(8): 1781-1789.
  4. 4. Topal B, Leys E, Ectors N, et al. Determinants of complications and adequacy of surgical resection in laparoscopic versus open total gastrectomy for adenocarcinoma [J]. Surg Endosc, 2008; 22(4): 980-984.
  5. 5. Person B, Cera SM. Prolonged postlaparoscopy carbon dioxide pneumoperitoneum [J]. Surg Laparosc Endosc Percutan Tech, 2008; 18(1): 114-117.
  6. 6. Fuganti PE, Rodrigues Júnior AJ, Rodrigues CJ, et al. A comparison of the effects of pneumoperitoneum and laparotomy on natural killer cell mediated cytotoxicity and Walker tumor growth in Wistar rats [J]. Surg Endosc, 2006; 20(12): 1858-1861.
  7. 7. Kosugi C, Ono M, Saito N, et al. Port site recurrence diagnosed by positron emission tomography after laparoscopic surgery for colon cancer [J]. Hepatogastroenterology, 2005; 52(65): 1440-1443.
  8. 8. Hirabayashi Y, Yamaguchi K, Shiraishi N, et al. Port-site metastasis after CO2 pneumoperitoneum: role of adhesion molecules and prevention with antiadhesion molecules [J]. Surg Endosc, 2004; 18(7): 1113-1117.
  9. 9. 田永剛， 許軍， 代文杰， 等. 人工氣腹對結(jié)腸癌細胞增殖影響的實驗研究 [J]. 中華普通外科雜志, 2007; 22(8): 623-626.
  10. 10. 馬君俊， 馮波， 張軼， 等. CO2氣腹對結(jié)腸癌細胞侵襲能力影響的體外研究 [J]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(5): 512-515.
  11. 11. 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.
  12. 12. Tan BJ, Dy JS, Chiu PY, et al. Effects of pneumoperitoneal gases and pressures on transitional cell carcinoma adhesion, growth, apoptosis and necrosis: an in vitro study [J]. J Urol, 2005; 174(4 Pt 1): 1463-1467.
  13. 13. Peng Y, Zheng M, Feng B, et al. Hyperthermic CO2 pneumoperitoneum induces apoptosis in human colon cancer cells through Bax-associated mitochondrial pathway [J]. Oncol Rep, 2008; 19(1): 73-79.
  14. 14. 王廣義， 孟憲瑛， 顧建華， 等. CO2氣腹對腫瘤細胞種植與生長的影響 [J]. 中國普外基礎(chǔ)與臨床雜志, 2004; 11(2): 133-135.
  15. 15. Ordemann J, Hflich C, Braumann C, et al. Impact of pneumoperitoneum on expression of E-cadherin, CD44v6 and CD54 (ICAM-1) on HT-29 colon-carcinoma cells [J]. Zentralbl Chir, 2005; 130(5): 405-409.
  16. 16. Yavuz Y, Rnning K, Lyng O, et al. Effect of carbon dioxide pneumoperitoneum on tissue blood flow in the peritoneum, rectus abdominis, and diaphragm muscles [J]. Surg Endosc, 2003; 17(10): 1632-1635.
  17. 17. Schmidt AI, Reismann M, Kübler JF, et al. Exposure to carbon dioxide and helium reduces in vitro proliferation of pediatric tumor cells [J]. Pediatr Surg Int, 2006; 22(1): 72-77.
  18. 18. Ishida H, Hashimoto D, Nakada H, et al. Increased insufflation pressure enhances the development of liver metastasis in a mouse laparoscopy model: possible mechanisms [J]. Surg Endosc, 2002; 16(2): 331-335.
  19. 19. 張浩波， 王灝， 鄭民華. 持續(xù)性CO2氣腹影響腹腔鏡手術(shù)切口腫瘤細胞種植的實驗研究 [J]. 中國普外基礎(chǔ)與臨床雜志, 2002; 9(1): 16-18.
  20. 20. 石彥， 郝迎學(xué)， 雷曉， 等. 模擬CO2氣腹對人胃癌MKN-45細胞增殖和細胞周期的影響 [J]. 第三軍醫(yī)大學(xué)學(xué)報, 2007; 29(23): 2274-2276.
  21. 21. Tosun M, Samli H, Arikan Y, et al. The effects of CO2 pneumoperitoneum on the apoptotic index in the peritoneum [J]. Adv Ther, 2007; 24(4): 883-889.
  22. 22. Nesek-Adam V, Mrsic＇ V, Smiljanic＇ A, et al. Pathophysiologic effects of CO2-pneumoperitoneum in laparoscopic surgery [J]. Acta Med Croatica, 2007; 61(2): 165-170.
  23. 23. Wildbrett P, Oh A, Naundorf D, et al. Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function [J]. Surg Endosc, 2003; 17(1): 78-82.
  24. 24. Kim ZG, Mehl C, Lorenz M, et al. Impact of laparoscopic CO2-insufflation on tumor-associated molecules in cultured colorectal cancer cells [J]. Surg Endosc, 2002; 16(8): 1182-1186.
  25. 25. Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [J]. Dis Colon Rectum, 2005; 48(12): 2217-2223.
  26. 26. 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.