胃癌前病变虚实关联证癌变趋向及规律研究

Research on Cancerization Tendency of Precancerous Lesion of Gastric Cancer and Its Laws

目的:研究胃癌前病变(Precancerous lesion of gastric cancer,PLGC)虚实关联证患者的癌变趋向及演变规律。方法:多中心临床协作,选择324例PLGC属虚实关联证者进行为期两年的临床跟踪,同步检测血清肿瘤相关物质(tumor supplied group of factors,TSGF)或癌胚抗原(carcino-embryonic antigen,CEA)。结果:324例PLGC患者7类证型中两年内发生癌变29例,癌变率为9%。癌变率最高的证型依次是:湿热藴胃并/兼脾胃虚寒证16.7%,胃络瘀阻并/兼气阴两虚证13.2%,肝胃气滞并/兼脾胃虚寒证8%。TSGF水平高峰值出现在前两类证型上。癌变患者癌变前半年证候呈虚实多证兼夹态势,其虚证涉气血虚、肾虚占48%。结论:PLGC癌变证候具有虚实兼夹的多态性及虚涉气血虚、肾阴阳虚的特征性。

Objective ：To study syndrome developing types of canceration cases with precancerous lesion of gastric cancer（ PLGC） from Traditional Chinese Medicine syndrome. Methods：Adopting multi-center collaboration,324 cases of PLGC with Xu-Shi correlation syndrome were studied by setting up five observation ports for two years clinical pursuit. At equal pace, tumor supplied group of factors （ TSGF ） and carcino-embryonic antigen （ CEA ） were detected. Results ： Among seven types of Xu-Shi correlation syndrome of 324 cases,canceration cases were 29 ,accounted for 9%. Three types of syndrome of higher cancer rate were damp- heat accumulating stomach combining/concurrent asthenia-cold in the spleen and stomach, accounted for 16.7% ; stagnation in stomach collaterals combining/concurrent asthenia of both qi and yin, accounted for 13, 2% ;stagnation of liver and stomach qi combining/concurrent asthenia-cold in the spleen and stomach, accounted for 8%. Detection of TSGF showed that the first two types had higher value. The syndromes of cauceration cases half a year before canceration showed excess and deficiency concurrent, and deficient syndrome involving in qi-blood and kidney deficiency accounted for 48%. Conclusion：PLGC canceration syndromes have polymorphism of excess and deficiency concurrent and characteristic of deficiency involving in qi-blood, kidney-yin and kidney-yang.