Our clinical practice of laparoscopic liver resection (LLR) had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma (HCC) over open liver resection (OLR), but the underlying mechanisms are not clear. This study was to find out whether systemic inflammation plays an important role. A total of 103 patients with early-stage HCC under liver resection were enrolled (LLR group, = 53; OLR group, = 50). The expression of 9 inflammatory cytokines in patients at preoperation, postoperative day 1 (POD1) and POD7 was quantified by Luminex Multiplex assay. The relationships of the cytokines and the postoperative outcomes were compared between LLR and OLR. Seven of the circulating cytokines were found to be significantly upregulated on POD1 after LLR or OLR compared to their preoperative levels. Compared to OLR, the POD1 levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-6 (IL-6), IL-8, and monocyte chemoattractant protein-1 (MCP-1) in the LLR group were significantly lower. Higher POD1 levels of these cytokines were significantly correlated with longer operative time and higher volume of blood loss during operation. The levels of these cytokines were positively associated with postoperative liver injury, and the length of hospital stay. Importantly, a high level of IL-6 at POD1 was a risk factor for HCC recurrence and poor disease-free survival after liver resection. Significantly lower level of GM-CSF, IL-6, IL-8, and MCP-1 after liver resection represented a milder systemic inflammation which might be an important mechanism to offer better short-term and long-term outcomes in LLR over OLR.

中文翻译：

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促炎细胞因子在腹腔镜和开腹肝切除术治疗早期肝细胞癌中的作用

我们的腹腔镜肝切除术（LLR）临床实践为肝细胞癌（HCC）患者取得了比开腹肝切除术（OLR）更好的短期和长期获益，但其潜在机制尚不清楚。这项研究旨在查明全身炎症是否发挥重要作用。共有 103 名接受肝切除术的早期 HCC 患者入组（LLR 组，= 53；OLR 组，= 50）。通过 Luminex Multiplex 检测对患者术前、术后第 1 天 (POD1) 和 POD7 的 9 种炎症细胞因子的表达进行定量。比较LLR和OLR细胞因子与术后结局的关系。与术前水平相比，LLR 或 OLR 后发现 POD1 中有 7 种循环细胞因子显着上调。与OLR相比，LLR组中粒细胞巨噬细胞集落刺激因子（GM-CSF）、白细胞介素6（IL-6）、IL-8和单核细胞趋化蛋白-1（MCP-1）的POD1水平显着降低。明显降低。这些细胞因子的 POD1 水平较高与手术时间较长和术中失血量较多显着相关。这些细胞因子的水平与术后肝损伤和住院时间呈正相关。重要的是，POD1处高水平的IL-6是肝切除后HCC复发和无病生存率差的危险因素。肝切除后 GM-CSF、IL-6、IL-8 和 MCP-1 水平显着降低，代表较轻的全身炎症，这可能是 LLR 比 OLR 提供更好的短期和长期结果的重要机制。