目的

探究结肠癌根治术与完整结肠系膜切除术（CME）对结肠癌患者血清miR-21、miR-25-3p表达的影响比较。

方法

纳入2021年6月至2023年6月收治的Ⅰ-Ⅲ期结肠癌患者，根据接受手术方式不同分为根治组（接受开腹结肠癌根治术）和CME组（接受腹腔镜下完整结肠系膜切除术），经倾向性匹配评分排除基线资料混杂因素影响，最终根治组与CME组各获得75例基线资料可比的患者。利用SPSS 27.0软件分析数据，并发症等计数资料以［例（%）］表示，采取χ²检验；肠管切除长度、miR-21及miR-25-3p表达量等计量资料以（±s）表示，采取独立样本t检验；生存分析采用Kaplan-Meier法并行Log-Rank检验。P＜0.05即具有统计学意义。

结果

CME组患者术中出血量显著低于根治组（P＜0.05），引流管拔除时间、排气时间、住院时间显著短于根治组（P＜0.05），淋巴结清扫数目显著多于根治组（P＜0.05），而两组的手术时间及肠管切除长度无显著差异（P＞0.05）；CME组患者并发症发生率显著低于根治组（P＜0.05）；术后1周，两组患者miR-21及miR-25-3p表达水平显著下降（P＜0.05），CME组显著低于根治组（P＜0.05）；通过Kaplan-Meier分析显示，两组患者的累积总生存率（100.0% vs. 98.7%）及累积无疾病进展生存率（97.3% vs. 90.7%）比较，差异均无统计学意义（P＞0.05）。

结论

相较于结肠癌根治术，CME治疗结肠癌更利于患者恢复，且并发症少，可有效降低潜在癌症转移风险，术后短期预后效果较好，值得推荐。

Objective

To explore and compare the influence of radical resection of colon cancer and complete mesocolic excision （CME） on the expressions of serum miR-21 and miR-25-3p in patients with colon cancer （CC）.

Methods

Patients with stage I-III CC were included from June 2021 to June 2023.According to different surgical methods，they were divided into radical resection group （open radical resection of colon cancer） and CME group （laparoscopic CME）.The propensity matching score was used to exclude the influence of confounding factors of baseline data.Finally，75 patients with comparable baseline data were obtained in radical resection group and CME group.SPSS 27.0 software was used for data analysis.Enumeration data such as complications were expressed by［ cases （%）］ and χ² test was performed.Measurement data such as bowel resection length and expressions of miR-21 and miR-25-3p were expressed as （±s） by adopting independent sample t test.Kaplan-Meier method and Log-Rank test were used for survival analysis.P＜0.05 was statistically significant.

Results

The intraoperative blood loss in CME group was significantly less than that in radical resection group （P＜0.05），and the drainage tube removal time，exhaust time and hospitalization time were significantly shorter than those in radical resection group （P＜0.05），and the number of lymph node dissection was significantly more （P＜0.05），but there were no significant differences in the surgical time and bowel resection length between groups （P＞0.05）.The incidence rates of complications in CME group were significantly lower than those in radical resection group （P＜0.05）.At 1 week after surgery，the expression levels of miR-21 and miR-25-3p in the two groups were decreased significantly （P＜0.05），and the expression levels were significantly lower in CME group than those in radical resection group （P＜0.05）.Kaplan-Meier analysis showed that there were no statistical differences in cumulative overall survival rate （100.0% vs. 98.7%） and progression-free survival rate （97.3% vs. 90.7%） between groups （P＞0.05）.

Conclusion

Compared with radical resection of colon cancer，CME is more conducive to the recovery of patients with CC，and the latter one has fewer complications and can effectively reduce the risk of potential cancer metastasis and has better postoperative short-term prognosis.