胃癌不同中医证型的细胞粘附分子表达

目的：检测细胞粘附分子（CD44v6）在胃癌不同中医证型的表达，探讨CD44v6与中医证型的关系。方法：手术前至床边辨证并详细记录有关资料。术后标本常规病理检查，并用免疫组化S-P法检测脾胃虚弱、肝胃不和、痰瘀毒结3证型胃癌104例和对照组浅表性胃炎30例组织中CD44v6蛋白的表达，结合相关临床病理特征，以及CD44v6在各个证型的表达情况进行分析。结果：CD44v6蛋白在胃癌组织中的阳性表达率为66．3％（69／104）显著高于浅表性胃炎组0％（0／30）（P〈0．01）。CD44v6表达强度与胃癌浸润深度、淋巴结转移及病理分期呈正相关（P〈0．01），与肿瘤的大小、分化程度无明显相关（P〉0．05）。胃癌不同证型之间CD44v6蛋白表达水平有显著差异（P〈0．01）；在痰瘀毒结证组高于脾胃虚弱证组，差异非常显著（P〈0．01），在肝胃不和证组高于脾胃虚弱证组，差异显著（P〈0．05），在肝胃不和证组与痰瘀毒结证组间，无显著差异（P〉0．05）。结论：CD44v6可作为胃癌浸润、转移及预后的参考指标之一。CD44v6差异表达在不同证型转移的过程中所起作用不同，不同证型的转移机制可能存在差异。CD44v6高表达与肝胃不和证和痰瘀毒结证胃癌存在显著正相关。CD44v6是胃癌肝胃不和证和痰瘀毒结证的相关基因之一。

Relationship between CD44v6 and TCM Syndrome Types of Gastric Carcinoma

Objective To examine the expressions of CD44v6 in different types of syndrome of TCM of gastric carcinoma,to investigate the relationship between CD44v6 and TCM syndrome types Methods On the day before operation,differentiation of syndrome was made.After the operation,the samples were under pathologically check,and immunohistochemically examined in 104 cases of gastric carcinoma of different syndrome types:spleen-stomach debility,liver-stomach disharmony and binding inphlegm-stasis-toxin,and then the results were compared with the expression of CD44v6 in 30 cases of superficial gastritis tissues.Results(1)The positive expression rate of CD44v6 in gastric carcinoma tissue was 66.3%(69/104),and that in the superficial gastritis group 0/30.(2)The expression of CD44v6 was in positive correlation(P<0.01)to the infiltration degree of gastric carcinoma,the metastasis of lymph node and to the pathological staging,but not related to the size and differentiation of tumor(P>0.05).(3)In gastric carcinoma tissues,the expression of CD44v6 protein was significantly different between different TCM syndrome types(P<0.01),and the expression in the binding in phlegm-stasis-toxin syndrome group was significantly higher than that in the spleen-stomach debility syndrome group(P<0.01),the expression in the liver-stomach disharmony syndrome group was higher than that in the spleen-stomach debility syndrome group(P<0.05).And the expression of CD44v6 protein in the liver-stomach disharmony syndrome group was not markedly different from that in phlegm-stasis-toxin syndrome group(P>0.05).Conclusion(1)CD44v6 can be one of the indices of the infiltration,node metastasis and prognosis of gastric carcinoma.(2)The different expressions of CD44v6 play different roles in the process of metastasis of different syndrome types and with different mechanism of metastasis.CD44v6 is a relevant gene to the syndrome of liver-stomach disharmony type and phlegm-stasis-toxin type of gastric carcinoma.(3)The high expression of CD44v6 is positively correlated to the metastasis of gastric carcinoma of liver-stomach disharmony syndrome and of phlegm-stasis-toxin syndrome.The more marked the evils of gastric carcinoma are,the higher the possibilities of their infiltration and metastases will be and the poorer the prognoses will be.