血管内皮生长因子与胃癌中医证型关系的研究

Study on the Relationship between Vascular Endothelial Growth Factor and Syndrome Type of Traditional Chinese Medicine in Patients with Gastric Carcinoma

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中文关键词: 血管内皮生长因子胃癌中医证型转移

英文关键词:vascular endothelial growth factor gastric carcinoma syndrome type of traditional Chinese medicine metastasis

基金项目:

作者	单位
陈文	福建医科大学第二附属医院
欧阳学农	南京军区福州总院
林求诚	福建省中医药研究院

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中文摘要:

目的检测血管内皮生长因子(vascular endothelial growthfator,VEGF)在胃癌不同中医证型的表达,探讨VEGF与中医证型的关系,揭示病与证之间的内在联系。方法手术前至床边辨证并详细记录有关资料。术后标本常规病理检查,并用免疫组化S-P法检测脾胃虚弱、肝胃不和、痰瘀毒结三证型胃癌104例和对照组浅表性胃炎30例组织中VEGF蛋白的表达,结合相关临床病理特征及VEGF在各个证型的表达情况进行分析。结果(1)实验组胃癌组织VEGF蛋白阳性表达率为81.7%(85/104),对照组无VEGF蛋白阳性表达,两组比较差异有显著性(P<0.01)。(2)VEGF表达强度与胃癌浸润深度、淋巴结转移及病理分期呈正相关(P<0.01),与肿瘤的大小、分化程度无明显相关(P>0.05)。(3)胃癌不同证型之间VEGF蛋白表达水平差异有显著性(P<0.01),痰瘀毒结证组高于脾胃虚弱证组,差异有显著性(P<0.01),肝胃不和证组高于脾胃虚弱证组,差异有显著性(P<0.05),痰瘀毒结证组高于肝胃不和证组,差异有显著性(P<0.05)。结论(1)VEGF可作为胃癌浸润、转移及预后的指标之一。(2)VEGF差异表达在不同证型转移的过程中所起作用不同,不同证型的转移机制可能存在差异。VEGF是胃癌肝胃不和证和痰瘀毒结证的相关基因。(3)VEGF高表达与肝胃不和证和痰瘀毒结证胃癌的转移存在显著正相关,提示胃癌邪实越明显,其浸润转移的机率越高,预后越差。

英文摘要:

ObjectiveBy detecting the expression of vascular endothelial growth factor(VEGF)in different syndrome types of traditional Chinese medicine(TCM)in patients with gastric carcinoma(GC)to investigate the correlation of VEGF and TCM syndrome type for exploring the internal relationship between disease and syndrome.MethodsThe correlated clinical manifestations were recorded in detail and patient’s syndrome type was differentiated at beside before operation.After operation,pathological examination on the resected specimen was performed routinely.The expression of VEGF in 104 GC patients of three different syndrome types,i.e.Pi-Wei asthenia type(type 1),Gan-Wei disharmony type(type 2)and phlegm-stasis-poisons stagnant type(type 3)and in 30 patients with superficial gastritis(for control)were determined by immunohistochemical method.The expressions of VEGF in different syndrome types were analyzed by combining with correlated clinical pathological characteristics.Results(1)The VEGF protein positive expression rate in GC patients was 81.7%(85/104),it was significantly higher than that in the control group with positive rate being zero(P<0.01).(2)The intensity of VEGF expression was positively correlated with the depth of tumor infiltration,the extent of lymph node metastasis and the pathological staging of cancer(P<0.01),and showed no evident correlation with the size of tumor and its degree of cell differentiation(P>0.05).(3)Levels of VEGF expression in various syndrome types were significantly different(P<0.01),the highest expression showed in the type 3,the second in the type 2,and the lowest in the type 1,comparison between them all showed significant difference(P<0.01 for 3 vs 1,P<0.05 for 3 vs 2 and 2 vs 1).Conclusion(1)VEGF could be taken as an index for evaluating the infiltration,metastasis and prognosis of GC.(2)The different expressions of VEGF play different roles in the GC metastatic process of patients of different syndrome types,and the pathogenesis of GC metastasis may be probably various in different syndrome types.VEGF is the relevant gene of GC of type 2 and type 3.(3)High VEGF expression shows positive correlation with the GC metastasis of type 2 and 3,suggesting that the higher the intensity of evil excess,the more possibilities of tumor infiltration and metastasis and the worse the prognoses will be.

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