摘要
目的:探索中医脾虚证的病理生理学变化与胃黏膜癌前病变的关系。方法:对160例脾虚证胃黏膜均伴有肠上皮化生(IM)和/或不典型增生(AHP)患者,脾虚证分为脾气虚证(SQD)、脾阴虚证(SyinD)和脾虚气滞证(SDQS)3型和22例健康对照者为研究对象,在CM200FEG型透射电镜(TEM)直视下,对胃黏膜上皮细胞核与线粒体采用9100/60型能量色散X射线分析仪能测定微量元素Zn、Cu;采用IBAS2000型图像分析仪测定上皮细胞核DNA;采用即用型非生物素免疫组织化学(ElivisionTM Plus)方法检测胃黏膜组织切片p53、Ki67、CerbB2、P21ras表达。结果:胃黏膜上皮细胞核DNA、Zn、Cu量变和p53、P21ras、CerbB2和Ki67阳性表达率,随着SQD、SyinD和SDQS组的顺序递增;而线粒体Zn、Cu,则随着以上各组的顺序递减,组间有显著性差异(P<0.05或P<0.001)。以上各项检测指标,在IMⅡb和ATP++组的变化与CA相近,无显著性差异;SDQS组与胃癌间在分子生物学上也无显著性的差异。结论:临床上发现SDQS慢性胃炎胃黏膜伴有ATP++、IMⅡb要高度警惕突发癌变的倾向,要定期随访,有利于发现早期胃癌。
Objective： To explore the relationship between the pathophysiological changes in TCM spleen deficiency syndromes and precancerous lesion of gastric mucosa. Method： 160 cases with spleen deficiency syndromes accompanied by gastric mucosa intestinal metaplasia, IM and / or atypical hyperplasia, AHP, （spleen deficiency is divided into spleen qi deficiency or SQD, spleen yin deficiency or SyinD and spleen deficiency with qi stagnation or SDQS） and 22 cases in health control group were taken as the study object. The detection was conducted on such trace elements as Zn, Cu of gastric mucosa epithelial cell nuclei and mitochondrion under the direct view of CM200FEG -TEM by adopting 9100/60 - Energy Dispersion X-ray Analyzers; detection was conducted on epithelial cell nucleus DNA by using IBAS2000 image analyzer; detection was conducted on the expression of P53,Ki67,CerbB2,P21^TM in gastric mucosa tissue slices by adopting ElivisionTM Plus＇. Result： The quantitative changes of gastric mucosa epithelial cell nucleus DNA, Zn, Cu and the positive expression rates of P53,P21^TM,CerbB2 and Ki67 increased in the sequence of SQD group,SyinD group and SDQS group, while mitochondrial Cu, Zn decreased in the same sequence, there was significant difference between the groups（P〈0.05,P〈0.01）. The changes of above indexes between the groups of IM Ⅱ b, ATHP^＋＋ were similar to CA, with no significant difference between groups; there was no significant difference between SDQS group and gastric cancer group in molecular biology.Conclusion： If it is clinically found that the gastric mucosa of SDQS chronic gastritis is accompanied by ATHP, IMⅡ b, pre-treatment should be taken against the tendency of immediate cancerous lesion, which calls for periodical follow-up visit and contributes to finding earlier gastric cancer.
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2009年第9期1236-1241,共6页
China Journal of Traditional Chinese Medicine and Pharmacy
