胃粘膜异型增生的微观辨证分型与核仁组成区嗜银蛋白含量变化及随访研究

The Relationship between Microdifferentiation of Syndromes for Aty- pical Hyperplasia of Gastric Mucosa and the Contents of AgNORs and Its Implications during the Follow-up Period of Lesion

目的 探讨胃粘膜异型增生中医微观辨证分型与细胞核仁组成区嗜银蛋白（ＡｇＮＯＲ）含量及临床随访结果的关系。方法 应用中医脏腑辨证理论与图象分析的方法对１２０例胃粘膜异型增生进行内镜下微观辨证分型与ＡｇＮＯＲ定量分析，同时进行临床随访研究。结果 胃络瘀滞型与胃络灼伤型胃粘膜的ＡｇＮＯＲ每核颗粒均数与大颗粒均数均较胃热型与胃寒型明显增高，有显著意义（Ｐ＜０．０１）。对其中６３例进行６～７２个月（平均２４个月）的随访，癌变组中胃络瘀滞型粘膜（２３／３０）明显高于未癌变组（９／３３），差异有显著意义（Ｐ＜０．０１）。结论 胃络瘀滞型胃粘膜异型增生与癌变关系密切，在辨证施治中应给予重视。

objective To study the relationship betw een microdifferentiation of syndromes of heterotypic proliferation of gastric mucos a and analysis on AgNOR contents and its significance of follow-up study. Method 120 cases of heterotypic proliferation of gastric mucosa were m icro differentiated and classified into four types under endoscopy according to the v isceral differention theory of traditional Chinese medicine. The nucleolar or g amizer region (AgNOR) of its paraffin sections was quantatively determined by im age analysis technique. Result The AgNOR sites and its large granu la r per nucleus in the groups of Gastric Venation Stagnancy type (GVS) and Gastri c Venation Burn type (GVB) were higher than those of the groups of Gastric Heat Ty p e(GH) and Gastric Cold Type (GC)(P<0.05～0.01). Sixty-three cases we re followed up for 6 to 72 months. There were 23 cases of GVS in the 30 cases o f cancer formation group, but nine in 33 cases of no cancer formation group (P<0.01). Conclusion Heterotypic proliferation of gas tric muco sa of GVS type has a close relationship to canceration and more attention Should be paid to it in treatment.