摘要
我国是食管癌高发国家,90%以上的为食管鳞癌,食管上皮内瘤变向食管鳞癌转变过程中的重要发病环节为上皮内瘤变细胞异常的增殖、迁移及大量新生的微血管。目前食管癌前病变进展为食管癌的研究多聚焦在环境、遗传基因易感等多方面,如炎症因子、血管内皮生长因子(VEGF)信号通路转导异常、p53基因突变、DNA甲基化等,部分药理学研究证实中药可以起到抑制炎性因子、调节异常信号通路及改善微环境等作用。大量食管癌患者发病时已处于疾病的中晚期,即便经过积极的综合治疗5年生存率仍较低,晚期患者因食管梗阻及肺部感染生存质量堪忧,因此疾病的早期预防逐渐凸显出重要性。对食管癌前病变患者的早干预符合临床的需求,同时也是中医传统“治未病”理论的体现,中医药的作用机制及临床疗效已逐渐得到证实和推广,因此具有一定临床意义;同时探索简便、经济有效的中医药干预措施符合临床诊疗规范及中医现代化,可推动经典走向临床。
China has a high incidence of esophageal cancer,more than 90%of which are esophageal squamous cell carcinoma(ESCC).Abnormal proliferation,migration and new microvessels of intraepithelial neoplasia cells are the important pathogenic links in the transformation from esophageal intraepithelial neoplasia(EIN)to ESCC.Studies on the progression of esophageal precancerous lesions into esophageal cancer mostly focus on environment and genetic susceptibility,such as inflammatory factors,abnormal vascular endothelial growth factor(VEGF)signaling pathway transduction,p53 gene mutation,and DNA methylation.Some pharmacology studies have confirmed that traditional Chinese medicine(TCM)can inhibit inflammatory factors,regulate abnormal signaling pathways and improve the microenvironment.A large number of patients with esophageal cancer have been found to be in advanced stage,and the 5-year survival rate is low even after active treatment.The quality of life of patients in advanced stage is worrying due to esophageal obstruction and lung infection,and therefore,early prevention is important.Early intervention in patients with esophageal precancerous lesions is in line with clinical needs and embodies the TCM theory of“treating disease before its onset.”The mechanism of action and clinical efficacy of TCM has been gradually confirmed and promoted,with certain clinical significance.To explore simple,economical and effective TCM intervention measures conforms to the clinical diagnosis and treatment standards and the modernization of TCM.
作者
苏菲
贾立群
程志强
邓超
娄彦妮
SU Fei;JIA Li-qun;CHENG Zhi-qiang;DENG Chao;LOU Yan-ni(China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第9期242-247,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
中日友好医院“菁英计划”人才培育工程(ZRJY2021-TD05)
国家自然科学基金项目(82174223)。
关键词
食管上皮内瘤变
食管癌
早期预防
中医治疗
esophageal intraepithelial neoplasia
esophageal cancer
early prevention
traditional Chinese medicine(TCM)therapy
