胃黏膜异型增生微观辨证分型CdX2基因表达及随访研究

[目的]探讨胃脘痛胃黏膜异型增生患者中医微观辨证分型与CdX2基因蛋白表达的意义及与临床随访结果的关系.[方法]应用中医脏腑辨证理论与ABC免疫组化方法对120例胃脘痛胃黏膜异型增生患者进行胃镜下微观辨证分型与CdX2基因蛋白表达的免疫组化分析,同时进行临床随访研究.[结果]胃络瘀滞型与胃络灼伤型患者胃黏膜CdX2基因蛋白表达阳性率(37.5%、66.7%)较胃寒型与胃热型(6.7%、12.5%)明显增高(P＜0.01),其中具有完整随访结果者63例,随访时间6～72个月(平均24个月),其癌变者中胃络瘀滞型(76.7%)明显高于未癌变者(27.3%)(P＜0.01).[结论]中医微观辨证分型与CdX2基因蛋白表达有关,对辨别胃黏膜异型增生的癌变性质具有重要意义,胃络瘀滞型胃黏膜异型增生与癌变关系密切,在辨证施治中应给予重视.

Relationship between microcosmic distinguish type of gastric dysplasia and the expression of CdX2 and its significance in follow-up study

bjective] To study the relationship between microcosmic distinguish type of gastric precancerous lesions and the expression of CdX2 and its significance in follow - up study. [Methods] One hundred and twenty cases of gastric precancerous lesions (dysplasia and metaplasia) were microcosmic divided distinguishally into four types by endoscopies according to Zang - fu distinguish theory of traditional Chinese medicine. The expression of CdX2 was studied by ABC immunohistochemical method. [Results] The expression of CdX2 in the Type Gastric Net Resort (TGNR) and Gastric Net Burn (TGNB)(37.5 % ,66.7 % ) were higher than that of the groups of Type Gastric Cold (TGC) and Type Gastric Hot ( TGH ) (6. 7 % , 12. 5 % ) ( P < 0. 01). Sixty-three cases were followed up for 6 to 72 months. There were 23 cases of TGNR in the 30 cases of cancer formation group, but 9 in 33 cases of no cancer formation group ( P < 0. 01). [Conclusion] The gastric precancerous lesions (dysplasia and metaplasia ) with TGNR have a close relationship to cancer formation, and need to pay more attention in the distinguish treatment.