摘要
目的探讨术前中医症型对乳腺癌预后判断价值及VEGF-C在不同中医症型的表达差异。方法收集91例术前不同症型乳腺癌患者临床资料和随访资料,按照年龄、肿瘤最大径、ER表达、分子分型、淋巴结转移、分级、TNM分期进行分组。术前患者舌苔脉象及乳腺局部和全身症状分为肝郁痰凝型、冲任失调型、正虚毒炽型。采用免疫组化方法检测癌组织VEGF-C的表达。结果不同中医症型癌组织VEGF-C的表达有差别(P<0.05)。乳腺癌复发率与分子分型、淋巴结转移、分期、分化及中医分型有关(P<0.05)。Kaplan-Meier生存曲线Log-rank检验显示中医症型、TNM分期、分子分型、肿瘤分化无病生存期有差别(P<0.05)。Cox多因素分析显示中医症型、分子分型、肿瘤最大径是独立预后因素。结论术前按照肝郁痰凝型、冲任失调型、正虚毒炽型3种症型进行乳腺癌分型判断预后有一定价值。正虚毒炽型预后差,淋巴结转移率高。
Objective To investigate the prognostic value of preoperative TCM syndromes on breast cancer and VEGF-C expression in different TCM syndromes. Methods According to the clinical pathological features and follow-up data, 91 cases of breast cancer patients with different preoperative TCM syndromes were grouped based on age, maximum of tumor diameter, ER expression, molecular type, lymph nodes metastasis, differentiation and TNM stage. The patients were classified into liver depression and sputum blocking, disorder of chong ren meridian, healthy qi deficiency and exuberance of pathogenic qi according to tongue coating, pulse and mammary gland, local and systemic symptoms. VEGF-C was detected by immunohistochemistry. Results VEGF-C expression in cancer tissue was significantly different among different types of TCM syndromes(P<0.05). The recurrence rate of breast cancer was significantly correlated with molecular type, lymph node metastasis, staging, differentiation and TCM classification(P<0.05). Log-rank test on Kaplan-Meier survival curve showed significant differences in disease-free survival among TCM syndromes, TNM stages, molecular types, and tumor differentiations(P<0.05). Cox multivariate analysis showed that TCM syndrome type, molecular type and maximum tumor diameter were independent prognostic factors. Conclusion It is valuable to forecasting prognosis according to the three types of liver depression and sputum blocking, disorder of chong ren meridian, healthy qi deficiency and exuberance of pathogenic qi before operation. The prognosis of healthy qi deficiency and exuberance of pathogenic qi is the worst and with higher lymph node metastasis.
作者
王媛媛
吴佩莼
黄盈
姚晓东
刘春鹏
吴璇
王少洪
WANG Yuan-yuan;WU Pei-chim;HUANG Ying;YAO Xiao-dong;LIU Chun-peng;WU Xuan;WANG Shao-hong(Department of Pathology,Shantou Central Hospital and the Affiliated Shantou Hospital of Sun Yat - Sen University,Shantou 515041,Guangdong,China)
出处
《广东医学》
CAS
2019年第5期642-646,共5页
Guangdong Medical Journal
基金
广东省中医药管理局面上科研项目(编号:20172124)
关键词
中医症型
乳腺
预后
TCM syndrome type
breast
prognosis
