| 张冬英 吴耀南 张玉凤.p53、CerbB-2在慢性萎缩性胃炎伴异型增生中医证型中的表达及其意义[J].实用中西医结合临床,2015,15(7):4-6,12 |
| p53、CerbB-2在慢性萎缩性胃炎伴异型增生中医证型中的表达及其意义 |
| The Expression and Significance of p53 and CerbB-2 in the Syndromes of Traditional Chinese Medicine of Chronic Atrophic Gastritis with Dysplasia |
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| DOI： |
| 中文关键词: 慢性萎缩性胃炎 异型增生 中医证型 癌基因 |
| 英文关键词: Chronic atrophic gastritis Gastric epithelial dysplasia Syndrome of TCM Oncogenes |
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| 中文摘要: |
| 目的：观察p53、CerbB-2表达在慢性萎缩性胃炎伴异型增生的中医各证型中的变化，探讨各证型之间在病理组织学及分子生物学水平上有无差异，探索中医辨证分型的客观指标。方法：选取146例慢性萎缩性胃炎伴异型增生患者进行中医辨证分型；采用Feulgen染色和免疫组织化学S-P法检测患者胃黏膜组织中p53、CerbB-2的表达情况。结果：（1）慢性萎缩性胃炎伴轻度异型增生即有癌基因的阳性表达，且轻、中、重度异型增生的p53阳性表达无显著性差异（P＞0.05），CerbB-2在轻、重度存在非常显著性差异（P＜0.01）。（2）p53、CerbB-2阳性表达率在慢性萎缩性胃炎伴异型增生的中医各证型间呈显著性差异（P＜0.05），且阳性表达率均存在胃络瘀血型＞胃阴不足型＞脾胃虚弱型＞脾胃湿热型＞肝胃不和型的递进关系。结论：（1）慢性萎缩性胃炎伴异型增生的中医辨证分型有其一定的病理组织学及分子生物学基础。（2）轻、中、重度异型增生均有癌变的可能，且随着异型增生程度的加重癌变的可能性逐渐增大。（3）慢性萎缩性胃炎伴异型增生的中医证型在病情严重程度上存在一定的轻重递进关系，具体表现为胃络瘀血型＞胃阴不足型＞脾胃虚弱型＞脾胃湿热型＞肝胃不和型。（4）检测p53、CerbB-2的表达可作为慢性萎缩性胃炎伴异型增生的诊断、分级和中医辨证分型的参考指标，并能协助指导临床诊治。 |
| 英文摘要: |
| Objective: Through observing the variety of the expression of p53 and CerbB-2 in the syndromes of traditional chinese medicine (TCM) of chronic atrophic gastritis with dysplasia, to study the difference of the syndromes of TCM in the pathologic histology and molecule biology level. Exploring objective and quantitative indexes of syndromes of TCM may be as a guide to TCM in preventing and treating the chronic atrophic gastritis with dysplasia. Methods:146 cases with chronic atrophic gastritis with dysplasia were divided into five types according to the syndrome differentiation of TCM. Image analysis technique and S-P immunohistochemical method were applied to detect the expression of p53 and CerbB-2 in stomach mucosa. Results: (1)There ever was the positive expression of oncogenes in the chronic atrophic gastritis with mild dysplasia, but no significant difference was found in the expression of p53 among mild, moderate or severe dysplasia(P＞0.05). While the difference expression of CerbB-2 between mild and severe dysplasia had very significant (P＜0.01). (2)The positive expression of p53 and CerbB-2 among all these syndromes of TCM had significant difference (P＜0.01), and they both had a significant stepwise crescendo tendency in the following sequence, disharmony between the liver and stomach, damp heat in the spleen and stomach, deficiency of the spleen and stomach, deficiency of stomach Yin, blood stagnation of the stomach. Conclusions: (1)The syndromes of TCM of chronic atrophic gastritis with dysplasia are on the basis of pathologic histology and molecule biology reliably, and it might play partly a good guidance in treating this disease. (2)Mild, moderate and severe dysplasia all had the possibility of carcinogenesis, and the possibility increased with the increment of the severity of dysplasia in gastric mucosa. (3)The worse of the syndromes of TCM of chronic atrophic gastritis with dysplasia increased by degrees, and the regular sequence was disharmony between the liver and stomach, damp heat in the spleen and stomach, deficiency of the spleen and stomach, deficiency of stomach Yin, blood stagnation of the stomach. (4)It has been approved that p53 and CerbB-2 could be used as some important indexes for diagnosis and classification of chronic atrophic gastritis with dysplasia, and for guidance of diagnosis and treatment. |
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