The Study On The Postoperative Insulin Resistance In The Colorectal Cancer Patients Which Used The FTS Treatment

ObjectTo prove the effects of FTS treatment which improve the postoperative insulin resistance in colorectal cancer patients, and to explore the mechanism, by means of comparing the levels of fasting blood glucose, serum insulin, growth hormon, cortisol and PI3K, AKT, p-AKT ser473, p-AKT thr308, GLUT4 mRNA and protein expression in postoperative colorectal cancer patients which treated respectively with FTS and traditional operation treatment.Methods(1)Cases:70 cases of colorectal cancer patients in Yan’an hospital were included from October 2012 to January 2014,35 males and 35 females, then they were randomly divided into FTS group(F group) and the traditional operation method group(C group).(2)Interventions:Group C was treated with the traditional operation mode, including fasting before surgery, the routine use of gastrointestinal decompression, open surgery, no analgesia after operation, taking food after anal exhaust. Group F received FTS treatment, including preoperative psychological intervention, giving sugar before operation, laparoscopic assisted surgery, keeping warm during operation, analgesia after operation, early feeding, early activity, and early pulling out catheter.(3)Specimen collection:The peripheral venous blood was collected 1 day before and 3 days after operation. The rectus specimens was took approximately 2g before the abdomen was closed.(4)Detection index:we sended the fasting blood to detect BG、INS、CORT and GH in the biochemical laboratory, to detect PI3K, AKT and GLUT4 mRNA expression levels by RT-PCR, and to measure the protein levels of PI3K, AKT, p-AKT473,308 phosphorylation protein and GLUT4 by western-blot.(5)Statistical analysis:the datas were analysed with the SPSS 17.0 statistical software.Result(1) The 70 patients included were operated successfully, and there were no complications.(2) Compared with group C, the postoperative blood glucose change magnitude was significantly lower(p<0.05).(3) Compared with group C, there was no significant difference in the change of INS in group F postoperative(p>0.05); the postoperative HOMA-B, HOMA-IR change magnitude in group F was significantly lower than group C(p<0.05).(4) There was no significant difference in the AKT, GLUT4 mRNA expression levels between the two groups (p>0.05). And there was higher expression levels of PI3K in group F(p<0.05). (5) Compared with the group C, the expression level of PI3K was significantly higher in group F(p<0.05). There was no significant difference in AKT and GLUT4 expression level of total protein between the two groups(p>0.05). However, the p-AKT ser473,p-AKT ser308 and membrane protein GLUT4 expression level was significantly higher in group F(p<0.05).Conclusion(1) Compared with the traditional operation treatment, the FTS treatment can lower the postoperative blood glucose, and the postoperative insulin resistance of patients was significantly improved, this was improtant to promote the rehabilitation of patients after surgery.(2) The mechanism which the FTS treatment improves postoperative insulin resistance may be as follows:by adjusting the key enzyme in insulin signaling pathway PI3K signaling pathway, then promoting the body’s glucose transporter function.