基于NF-κB/Bcl-2细胞凋亡通路探讨健脾通络解毒方对胃癌前病变的作用

Effect of Jianpi Tongluo Jiedu Formula on precancerous lesions of gastric cancer based on NF-κB/Bcl-2 cell apoptosis pathway

目的:研究健脾通络解毒方对胃癌前病变(PLGC)细胞凋亡的影响。方法:依据临床诊断及纳入标准入组的36例PLGC患者,予健脾通络解毒方干预治疗6个月,采集治疗前后症状变化及内镜下表现,应用免疫组化、RT-PCR等技术,检测治疗前后组织病理变化,细胞凋亡指数,凋亡信号通路(NF-κB/Bcl-2)上相关基因、蛋白表达(Bcl-2、Bax、NF-κB)等指标的变化。结果:①免疫组化蛋白表达:治疗后NF-κB、Bcl-2、Bax阳性表达率略为升高。经统计分析,治疗前后NF-κB积分与Bcl-2积分有明显变化,二者均存在治疗前后的差异,NF-κB(P<0.01)、Bcl-2(P<0.01),Bax积分有略升高变化,但差异无统计学意义。②细胞凋亡指数(TUNEL法):治疗后细胞凋亡指数(AI)值较治疗前有减低变化。③RT-PCR mRNA表达:Bcl-2 mRNA转录水平在治疗前表达为0.27±0.18,治疗6个月后为0.18±0.12,两者之间有显著性差异(P<0.05)。结论:健脾通络解毒方及其方药可通过促进细胞凋亡而对慢性萎缩性胃炎(CAG)伴肠上皮化生(IM)或伴有不典型增生(Dys)起到一定的治疗作用,从而达到预防PLGC向胃癌发展的作用。

Objective： To study the effect of Jianpi Tongluo Jiedu Formula on cell apoptosis of precancerous lesions of gastric cancer. Methods： 36 cases of PLGC patients were selected according to clinical diagnosis and inclusion criteria and were treated by Jianpi Tongluo Jiedu Formula for 6 months. Changes in symptoms and endoscopic features before and after treatment were recorded. The histopathological changes, the cell apoptosis index, changes of apoptosis signaling pathway （NF-κB/Bcl-2） related gene and protein expression （Bcl-2, Bax, NF-κB） before and after treatment were detected by using immunohistochemical, RT-PCR technique. Results： q） cal expression： After treatment, the NF-κB, the Bcl-2, Bax positive expression rate slightly increased. Through statistical analysis, before and after treatment the NF-κB points and the Bcl-2 points had obviously changed, and both had differences before and after treatment, the NF-xB and Bcl-2 was significantly lowered （P〈0.01）. Bax points increased slightly, but there was no significant difference. （1）Apoptosis index （TUNEL method）： After treatment, apoptosis index （AI） decrease compared with before treatment. （2）Rt-PCR mRNA expression： The transcription expression level of Bcl-2 mRNA before treatment was （0.27±0.18）. After 6 months of treatments, the Bcl-2 expression level was （0.18±0.12）, there were significant differences （P〈0.05）. Conclusion： Jianpi Tongluo Jiedu Formula and the herbs in the formula could achieve in a therapeutic effect in the CAG with IM or with Dys by promoting apoptosis; therefore reached the role of preventing PLGC patients from improving to GC.