原发性肺癌中医证型与TNM分期及肿瘤抗原相关性研究

目的：研究原发性肺癌患者中医证型与TNM临床分期及肿瘤抗原的相关性，为中医药防治原发性肺癌提供理论支持和用药指导。方法：将388例肺癌患者按照相关证型进行数据统计，分析肺癌患者的证型分布情况及与TNM临床分期及肿瘤标志物之间的相关性。结果：①临床TNM不同分期中，肺阴虚证在第I期的发病率明显高于第IV期；脾气虚证在第IV期的发病率明显高于第I期；肺气虚证、瘀阻肺络证、肺阴虚火旺证在不同分期中的发病率均无明显差异。②CEA在肺阴虚火旺证中明显高于肺阴虚证、肺气虚证及瘀阻肺络证。NSE在肺阴虚火旺证中异常升高比例明显高于其它证型。CYFRA21-1在肺阴虚火旺证及瘀阻肺络证异常升高比例明显高于肺气虚证。结论：①肺癌患者中医证型与TNM临床分期具有一定相关性。肺阴虚证贯穿于肺癌始终，在早期阶段尤为明显；脾气虚证则多见于肺癌的晚期阶段。②肺癌患者不同中医证型与肿瘤抗原CEA、NSE、CYFRA21-1的异常升高具有一定相关性。

Related Research on Traditional Chinese Medicine Syndromes and TNM Staging and Tumor Antigen in Primary Lung Cancer

This article was aimed to study the relevance on traditional Chinese medicine (TCM) syndromes and TNM staging and tumor antigen in primary lung cancer, in order to provide theoretical supports for TCM prevention and treatment as well as medication guidance of primary lung cancer. Statistical data from 388 lung cancer patients were analyzed according to the relevance TCM syndromes, in order to find the relation between syndrome distribution of lung cancer and TNM staging and tumor antigens. The results showed that in TNM staging, the incidence of lung-yin deficiency syndrome in I stage was apparently higher than that in IV stage; the incidence of spleen-qi deficiency syndrome in IV stage was apparently higher than that in I stage; and there was no obvious difference in lung-qi deficiency syndrome, stasis obstructing lung collateral syndrome or lung-yin deficiency with fire-excess. The proportion of CEA in lung-yin deficiency with fire-excess syndrome was significantly higher than that in lung-yin deficiency syndrome, lung-qi deficiency syndrome, and stasis obstructing lung collateral syndrome. The proportion of abnormal increasing of NSE in lung-yin deficiency with fire-excess syndrome was significantly higher than other syndromes. The proportion of abnormal increasing of CYFRA21-1 in lung-yin deficiency with fire-excess syndrome and stasis obstructing lung collateral syndrome was significantly higher than that in lung-qi deficiency syndrome. It was concluded that there were certain relevance between TCM syndromes and TNM staging in lung cancer. Lung-yin deficiency syndrome, which existed in all stages of lung cancer, was the most obvious in the early stage. Spleen-qi deficiency syndrome was commonly seen in the advanced stage of lung cancer. There were certain relevance between different TCM syndromes and the abnormal increasing of tumor antigens including CEA, NSE and CYFRA21-1.