The Influence Of Different Surgical Methods On Serum IL-6and TNF-α In Patients With Gastric Cancer

Objective:To explore the relationship between serum interleukin-6(IL-6) and tumor necrosis factor-alpha(TNF-α) with clinical pathological stage in patients with gastric cancer, and their significance in clinical diagnosis and treatment; To study which surgical method has less influence on immune system of patients by compareing the effect of laparoscopic gastrectomy and laparotomy gastrectomy.Methods:58cases of patients with gastric cancer (42cases in laparoscopic group,16cases in laparotomy group) and10cases of healthy physical examinees were selected in Lanzhou General Hospital from January to June in2012. The healthy controls’serums were collected, and the serums of patients with gastric cancer were obtained at specially designed time:the day before operation, postoperative first day, the third day and the seventh day. Serum IL-6and TNF-α in study objects were measured by enzyme-linked immune sorbent assay(ELISA). The relationship between IL-6and TNF-α with clinical pathology of gastric carcer, and the influence of different surgical methods on serum IL-6and TNF-α in perioperative patients with gastric carcer were analyzed using SPSS18.0.Results:1. Serum IL-6levels in patients with gastric cancer before surgery were significantly higher than healthy group (before surgery235.93±32.22ng/L, healthy group35.61±8.09ng/L, P＜0.05), and serum TNF-α levels were also significantly higher than healthy group (before surgery227.30±24.59ng/L, healthy group85.22±9.19ng/L, P＜0.05).2. Serum IL-6and TNF-a levels were significantly correlated with depth of tumor invasion, tumor lymph node metastasis, organ metastasis and TNM stage(P<0.05), but no association was found with age, gender and tumor differentiation of patients (P>0.05).3. Serum IL-6and TNF-α levels in laparoscopic group and laparotomy group before surgery had no significant difference (P>0.05), but both higher than healthy group(P<0.05); IL-6was highest on the1st day postoperatively, and laparotomy group was obviously higher than the laparoscopic group (P＜0.05); on the3rd day postoperatively IL-6in laparoscopic group returned to preoperative level, obviously lower than the laparotomy group (P<0.05); on the7th postoperative day, serum IL-6in laparotomy group declined to normal levels. Serum TNF-α levels were highest on the1st day postoperatively in both laparotomy group and laparoscopic group, but higher in laparotomy group(P<0.05); on the3rd day postoperatively the levels returned to preoperative levels, and on7th postoperative day the levels were lower than preoperative level, but still higher than the healthy group(P<0.05).Conclusion:Serum IL-6and TNF-α levels are associated with the depth of tumor invasion, tumor lymph node metastasis, organ metastasis and TNM stage in patients with gastric cancer, and laparoscopic gastrectomy have smaller influence on serum IL-6and TNF-α levels in patients.