基于胸腔镜技术探索BAC证型与肿瘤转移关系

Research on Relationship between Bronchioloalveolar Carcinoma Syndromes and Metastasis by Thoracoscopic Techniques

目的:揭示细支气管肺泡细胞癌(BAC)证型与肿瘤转移相关性,为该病辨证论治及预后评估提供新的科学依据,进而证实内外合诊科学性及可行性。方法:60例BAC患者按照虚实证型平均分成两组,同期收集体检肺部良性结节者30例,设为对照组,各组患者术前一天行生活质量(FACT-L)评分,术中运用胸腔镜技术取出靶组织活检,开展肿瘤转移相关指标的对照研究。结果:BAC两证型组患者FACT-L评分与对照组比较,前者生理状况、社会/家庭状况、情感状况、功能状况、附加状况评分及总评分显著高于后者(P<0.01),而虚证组患者较实证组评分偏高,且差异有统计学意义(P<0.01);BAC两证型组患者肿瘤组织与良性结节组织比较,前者VEGF、MMP-2、MMP-9皆高于后者(P<0.01),两证型组间比较,上述指标虚证患者高于实证患者(P<0.01)。结论:细支气管肺泡细胞癌证型与肿瘤转移存在相关性。

This study was aimed to reveal the relationship of bronchioloalveolar carcinoma （BAC） syndromes and metastasis, in order to provide new scientific basis for syndrome differentiation, treatment and prognostic assessment, which proved the scientificity and feasibility of internal and external inspection. A total of 60 BAC cases were divid- ed into two groups according to the syndrome of deficiency and excess. Another 30 cases of benign pulmonary nod- ules were simultaneous collected in the physical examination as control group. The quality of life （FACT-L） wasscored one day before operation for patients in each group. The thoracoscopic technique was used in the biopsy of targeted tissues, in order to reveal indicators related with metastasis. The results showed that the comparison of FACT-L score of patients from two syndromes of BAC and that of the control group indicated that the score of physi- ological state, social/family condition, emotional condition, functional situation, additional situation and total score of the previous one were obviously higher than the latter one （P 〈 0.01）. And the score of patients in the deficiency syndrome group was higher than that of the excess group with statistical significance （P 〈 0.01）. The comparison be- tween the tumor tissues of patients from two syndromes of BAC and the benign pulmonary nodules showed that the VEGF, MMP-2, MMP-9 of the previous one were higher than the latter one （P 〈 0.01）. The comparison between two syndromes showed that all indexes of the deficiency syndrome were higher than the excess syndrome （P 〈 0.01）. It was concluded that syndromes of BAC was related with metastasis.