胃癌证型与肿瘤增殖的关系

Relationship between gastric carcinoma traditional Chinese medicine classifications of syndrome and tumor proliferation

目的:探索胃癌中医证型与肿瘤增殖的关系方法:胃癌患者91例,术前按中医辨证分型标准归类成6型,术后标本用免疫组化Envision法检测胃癌组织Ki67与Cyclin E的蛋白表达,观察不同证型肿瘤增殖差异．结果:Ki67,Cyclin E阳性表达率分别为 98．90％(90／91),72．53％(66／91)．Cyclin E的表达与胃癌病理分型(P=0．0394)及远处转移(P =0．0096)存在相关性,女性患者有无远处转移与Cyclin E表达有统计学意义(P=0．0193),有远处转移的患者表达较高．Ki67与预后相关因素未见相关性．Ki67的表达与证型存在相关性 (P=0．0377),肝胃不和型与痰湿凝结型、气血双亏型Ki67表达存在差异,肝胃不和型高于痰湿凝结型(P<0．01)、气血双亏型(P<0．05), 胃热伤阴型与痰湿凝结型Ki67存在差异,胃热伤阴型高于痰湿凝结型(P<0．05);Cyclin E的表达各证型未见统计学差异(P<=0．1254)．结论:Cyclin E可作为判断胃癌预后的重要指标．胃癌不同证型存在部分增殖差异,Ki67与胃癌证型相关,Cyclin E与证型无关．

AIM： To study the relationship between gastric carcinoma traditional Chinese medicine （TCM） classifications of syndrome and tumor proliferation. METHODS： Ninety-one patients with gastric carcinoma were assigned into 6 groups according to TCM classification of syndrome criteria before operation. Specimens prepared from operation were detected for Ki67 and Cyclin E protein expression by EnVision method of immunohistochemistry. RESULTS： The positive rates of Ki67 and Cyclin E expression were 98.90% （90/91） and 72.53% （66/91）, respectively, in gastric carcinoma. The expression of Cyclin E protein was correlated with the histological types （P = 0.0394） and distant metastasis （P = 0.0096）. There was significantly positive relationship between Cyclin E protein expression and distant metastasis in female patients （P = 0.0193）. The expression of Ki67 protein had significant correlations with gastric carcinoma TCM classifications of syndromes （P = 0.0377）, but the expression of Cyclin E protein did not （P = 0.1254）. The expression of Ki67 in the syndrome of ＂Incoordination between the Liver and Stomach＂ was significantly higher than that of ＂Phlegm-damp Coagulation＂ （P 〈 0.05） or ＂Deficiency of both Qi and Blood＂ （P 〈 0.01）, and it was more significant in the syndrome of ＂Stomach-heat and Deficiency of Stomach-yin＂ than that of ＂Phlegm-damp Coagulation＂ （P 〈 0.05）. CONCLUSION： Cyclin E can be used as an important marker in the judgment of gastric carcinoma prognosis. Tumor proliferation is partly different among different gastric carcinoma TCM classifications of syndromes, with which Ki67 protein expression is correlated.