The effects of total laparoscopic hysterectomy combined with pelvic lymphadenectomy on the apoptosis rate of cervical cancer cells and its related mechanisms

WANG Lihua

doi:10.3969/j.issn.1002-7386.2018.08.007

Abstract：Objective To analyze the effects of total laparoscopic hysterectomy combined with pelvic lymphadenectomy on the apoptosis rate of cervical cancer cells and its related mechanisms.Methods Eighty patients with cervical cancer and 40 patients with uterine fibroids who were admitted and treated in our hospital from March 2014 to March 2016 were enrolled in this study. Among the 80 patients with cervical cancer, 40 patients underwent total laparoscopic hysterectomy combined with pelvic lymphadenectomy, whereas the other 40 patients underwent total abdominal hysterectomy combined with pelvic lymphadenectomy. The 40 patients with uterine fibroids were treated by laparoscopic hysterectomy. Flow cytometry was used to determine the apoptosis rate of cervical cancer cells before and after surgery in 40 patients with cervical cancer undergoing laparoscopic surgery. In addition, the expression levels of Trai L, Bcl2, MTA1, and NM23 genes were observed before and after laparoscopic hysterectomy, and compared with those in normal cervical cells before and after hysterectomy and those in cervical cancer cells before and after abdominal hysterectomy. Results The operation time in cervical cancer patients receiving laparoscopic hysterectomy was significantly longer than that in the patients receiving abdominal hysterectomy (P<0.05), however,the intraoperative blood loss, postoperative hospital stay and recovery time of gastrointestinal function in laparoscopic hysterectomy superior to those in abdominal hysterectomy(P<0.05). There were no significant differences in the incidence rates of postoperative complications between laparoscopic hysterectomy and abdominal hysterectomy (P>0.05). The preoperative apoptosis rate of cervical cancer cells was (26.54 ± 0.64)%, which was significantly higher than that (4.2 ± 0.17)% after laparoscopic surgery (P <0.05). The apoptotic rate was (5.08 ± 0.28)% after abdominal hysterectomy, as compared with that before surgery (P >0.05). The apoptosis rate of cervical cancer cells preoperatively was(18.26 ± 0.46)% in patients with uterine leiomyoma,however,which was(17.36 ± 0.57)% after laparoscopic surgery. The expression levels of the metastasis-inhibiting gene NM23 and the apoptotic gene Trail in cervical cancer cells were significantly increased after laparoscopic surgery,as compared with those before surgery,whereas the expression levels of metastasis-related gene MTA1 and the apoptosis-inhibiting gene Bcl2 were remarkably lower than those before surgery. Moreover the expression levels of Bcl2,MTA1,Trail,and NM23 in normal cervical cells did not vary with the changes in internal environment caused by laparoscopic surgery. Conclusion The laparoscopic hysterectomy for cervical cancer does not increase the proliferation and metastasis of cancer cells,or the incidence rate of postoperative complications, which suggests that the surgery method has excellent clinical efficacy and safety.