The Influence Of CO2 Pneumoperitoneum On The Expression Of Adhesion Molecules In Gastric Cancer

Objective:To investigate the influence of different pressures and duration of C02 pneumoperitoneum on the expression of adhesion molecules in Gastric Cancer.Methods:The expreesion of CD44v6 and ICAM-1 protein were deleted with Immunohistoche- mical ldpe-g-nvp method on 81 cases with gastric cancer treated by Open surgery from 2008 to 2010 and 55 cases with gastric cancer treated by Laparoscopic surgery in the corresponding period in Fujian Tumor Hospital in China. With all artificial pneumoperitoneum model in vitro,SGC-7901 stomach cancer cells were exposed to C02-insuffiation of different pressure(6mmHg,9mmHg,12mmHg and 1 5mmHg) for different duration(2h,4h,6h).The protein level of CD44v6 and ICAM-1 were measured 0 and 72 hours after CO₂-insufflation using immunocytochemistry and the mRNA level of these Adhesion molecule were detected by RT-PCR.Result:(1)By comparing specimens with gastric cancer in Sigmoidectomy group and in Laparoscopic group,we had the following results: the protein expression of CD44v6 and ICAM-1 in Laparoscopic group was below sigmoidectomy group, the difference of protein level of CD44v6 and ICAM-1was statistically significant(P<0.05).(2)According to the results of the expression of Cell adhesion molecules measured immunocytochemistry: Having been approved by 6mmHg,9mmHg CO2-insufflation pressure,the protein expression of CD44v6 and ICAM-1in SGC-7901 cell line increa- sed. With the extension of duration, each adhesion molecule expression gradually de- creases. In 12mmHg and 15mmHg groups, CD44v6 and ICAM-1 decreases with the extension of duration.These changes were statistically significant compared with treatment before(p<0.05). The changes of expression of Cell adhesion molecules returned to or even less than the control level by 72 hours(p<0.05). Semi-quantitative PCR detection show similar results.Conclusion: 1.In the existing laparoscopic surgery conditions, the expression of these adhesion molecules in gastric cancer were inhibited by CO₂-insufflation.2.The expression of these adhesion molecules was affected temporarily ang bidirec- tionally after the continuous CO₂-insufflation.3.The lower and shorter pressure of CO₂-insufflation(6mmHg,9mmHg,2h)may be promote the expression of these adhesion molecules in gastric cancer. 4.With CO₂-insufflation pressure and duration ascending,the increasing expression of the adhesion molecules were inhibited in gastric cancer.The higher and longer pressure of CO₂-insufflation (12mmHg,15mmHg,4h,6h) plays an important role in inhibiting the expression of the adhesion molecules.