摘要
目的探讨脾胃气虚证和湿热内蕴证溃疡性结肠炎(UC)患者肠黏膜活检组织中p53、KRAS、APC蛋白及增殖指数Ki-67的表达特点和意义。方法根据中医辨证分型及有无异型增生将64例UC患者分为脾胃气虚证组23例,湿热内蕴证组22例,脾胃气虚证伴低级别异型增生组9例,湿热内蕴证伴低级别异型增生组10例。选取同期肠镜活检组织呈轻度慢性炎者10例作为正常组,大肠癌患者11例作为大肠癌组。采用免疫组织化学方法检测各组患者肠黏膜组织内p53、KRAS、APC蛋白及Ki-67表达情况。结果UC各组患者肠黏膜组织内p53蛋白表达阳性和Ki-67位于隐窝上1/2者的比例均明显低于大肠癌组(P均<0.05);脾胃气虚证组和湿热内蕴证组p53蛋白表达阳性和Ki-67位于隐窝上1/2者的比例基本相同;脾胃气虚证伴低级别异型增生组p53蛋白表达阳性和Ki-67位于隐窝上1/2者的比例高于湿热内蕴证伴低级别异型增生组,但差异无统计学意义;UC各组患者肠黏膜组织内均未见KRAS蛋白和APC蛋白表达。结论脾胃气虚证伴低级别异型增生患者存在更高比例的肠黏膜上皮p53蛋白过表达及黏膜上皮增生活跃、缺乏成熟现象等癌变危险因素,对于脾胃气虚证伴低级别异型增生患者应加强随访和肠镜监测。
Objective It is to explore the immunohistochemical features and its significance of p53, KRAS, APC and Ki-67 in the ulcerative colitis （UC） patients with two different types of Chinese traditional medical syndromes. Methods 64 inpatients with UC were divided into four groups according to Chinese medical syndrome differentiation and classification with or without dysplasia： 23 cases of syndrome of spleen-stomach Qi deficiency （ group A） , 22 cases of syndrome of damp- ness-heat accumulation （ group B） , 9 cases of syndrome of spleen-stomach Qi deficiency with lower level dysplasia （ group C ） , 10 cases of syndrome of spleen-stomach Qi deficiency with lower level dysplasia （ group D）. 10 cases with mild chron- ic inflammation in intestinal tissue were selected as normal group, 11 cases with colorectal cancer as colorectal cancer group. The expression of p53, KRAS, APC and Ki-67 was detected in every group by immunohistochemistry methods. Re- sults The proportion of p53 over expression in intestinal mucosa and Ki-67 in the upper half of crypt in the patients in UC groups were significantly lower than that in eolorectal cancer group （ P 〈 0. 05）. The proportion of p53 over expression in intestinal mucosa and Ki-67 in the upper half of crypt in group A was the same as those in group B. The proportion of p53 over expression in intestinal mucosa and Ki-67 in the upper half of crypt in the patients in group C was higher than those in group D, but the difference was not significant. A negative KRAS and APC staining pattern were detected in all patients in UC groups. Conclusion The UC patients with syndrome of spleen-stomach Qi deficiency with lower level dysplasia have a higher proportion of intestinal epithelial p53 over expression and high risk factors of cancer such as epithelial hyperplasiaand lack of maturation, these patients should be given regular follow-up and colonoscopy screening.
出处
《现代中西医结合杂志》
CAS
2018年第1期1-4,22,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
国家自然科学基金资助项目(81202804)
