胃复春联合维甲酸治疗胃癌癌前病变的疗效及对Rb、C-erbB-2表达的影响

Weifuchun Tablets Combination with Retinoic Acid in Treatment of Gastric Precancerous Lesions and its Effect on Expression of Rb Gene and C-erb B-2 Gene

目的观察胃复春联合维甲酸治疗胃癌癌前病变的疗效及对Rb、C-erb B-2表达的影响,探讨二者干预胃癌癌前病变进展的可能机制,为胃癌的二级预防提供理论依据。方法通过胃镜活检、病理检查确诊获取异型增生(dysplasia,Dys)伴或不伴胃黏膜肠化(intestinal metaplasia,IM)122例,随机分为治疗组63例,对照组59例。治疗组用药为维甲酸、胃复春;对照组用药为奥美拉唑、硫糖铝。服药3月后再次由胃镜活检获取病理标本,采用免疫组化法检测治疗前后Rb、C-erb B-2表达情况。结果服药3个月后,治疗组有效率68.25%,对照组37.29%相比较有统计学意义(P<0.05);能上调Rb表达强度(U=2.543,P<0.05),下调C-erb B-2的表达(U=3.032,P<0.05),与对照组相比,差别有统计学意义(P<0.05),临床观察胃复春联合维甲酸无明显毒、副作用。结论胃复春联合维甲酸可促进胃黏膜异型增生的逆转,降低癌变风险,可能的作用机制之一是上调抑癌基因Rb的表达、下调癌基因C-erb B-2的表达,可用作胃癌的预防治疗。

Objective To investigate the effect of the Weifuchun tablets with combination Retinoic Acid tablet on gastric precancerous lesions and its regulative effect on the expression of the Rb gene and the C-erbB-2 gene. Methods One hundred and twenty-two patients with gastroscopy and pathology confirmed dysplasia（DYS）with or without intestinal metaplasia（IM）were classified randomly into treatment group and control group .The treatment group consisting of 63 patients was treated with a Weifuchun tablets,Retinoic Acid tablet,Omeprazole tablet and Sucralfate tablet.The other 59 patients were treated with Sucralfate tablet and Omeprazole tablet as control.Rb and C-erbB-2 protein were detected by the immunohistochemical method before and after the treatment. Results Compared with the control group 37.29% of effective power,the treatment group 68.25% was significantly improved after three months of treatment （P 〈0.05 ）.The abnormal expression of the Rb Gene and the C-erbB-2 Gene was found in both groups and effectly regulated by Weifuchun tablets and Retinoic Acid tablet. Conclusion The combination of Weifuchun tablets and Retinoic Acid tablet was effective in treating gastric dysplasia and intestinal metaplasia.It could reduce the risk of carcinogenesis of gastric precancerous lesions by reversing the gastric mucosa lesions and regulating the expression of tumor suppressor genes Rb,oncogene C-erbB-2.The combination of Weifuchun tablets and Retinoic Acid tablet could effectly be used in the treatment of precancerous lesions.