胃癌不同中医证型雌激素与孕激素受体表达差异

目的 探讨胃癌不同中医证型雌激素受体(ER)α、β和孕激素受体(PR)蛋白与mRNA的表达差异.方法 60例胃癌患者术前按中医辨证分为6型(实证:肝胃不和、瘀毒内阻、痰湿凝结;虚证:脾胃虚寒、胃热伤阴、气血双亏),术后标本免疫组化EnVision法检测肿瘤组织ERα、ERβ、PR蛋白表达,Sybr green荧光定量PCR法检测ERα、ERβ、PR mRNA表达,观察不同证型表达差异.结果 ERα、ERβ阳性率分别为15%、48.33%,证型间差异无统计学意义(P＞0.05);PR阳性率26.67%,6种证型间差异存在统计学意义(P＝0.010 4).ERαmRNA、ERβmRNA、PR mRNA表达水平分别为1.910±2.461、1.559±1.452、5.592±7.896.ERαmRNA、ERβmRNA表达6种证型间差异有统计学意义(P＜0.05),PR mRNA差异未见统计学意义(P＞0.05).虚实证型比较,ERα、ERβ、PR蛋白表达和ERβmRNA表达差异未见统计学意义(P＞0.05),ERαmRNA、PR mRNA表达差异存在统计学意义(P＝0.001,P＝0.028).结论 胃癌证型ERα、ERβ与PR在蛋白与基因上存在部分表达差异,可能为胃癌证型差异的物质基础之一.

Expressions of Estrogen and Progesterone Receptors among Different Traditional Chinese Medicine Syndromes in Gastric Carcinoma

Objective To explore the relationship between expressions of estrogen receptor（ER） α,ER β,progesterone receptor（PR） and different TCM syndromes in gastric carcinoma.Methods A total of 60 patients were divided into six groups（excess syndromes：disharmony between liver and stomach,interior retention of stagnant toxin,interior retention of phlegm and dampness;deficiency syndromes：deficiency-cold in spleen and stomach,insufficiency of both qi and blood,yin impairment due to stomach heat） according to TCM syndrome differentiation.Specimens were collected after operation.ER α,ER β and PR protein and mRNA expressions were detected by EnVision immunohistochemical method and Sybr green real-time quantitative PCR,respectively.Results The total positive rates of ER α,ER β and PR gene protein expressions were 15%,48.33% and 26.67% respectively.There was a significant difference in PR expressions among six different TCM syndromes（P=0.010 4）.The ER α,ER β and PR gene mRNA levels were 1.910±2.461,1.559±1.452 and 5.592±7.896 respectively.There were significant differences in ER α mRNA and ER β mRNA levels among six syndromes（P0.05）.However between deficiency and excess syndromes,significant differences were found in ERαmRNA（P=0.001） and PRmRNA（P=0.028） levels.Conclusion There are differences in the expressions of ER α,ER β and PR among different TCM syndromes in gastric carcinoma,which may be one of the material bases of different TCM syndromes.