虚实证候大肠癌患者肠组织CAF活性相关标记物差异分析

CAF Activity Related Markers Variance of Colorectal Cancer Patients with Excess or Deficiency Syndrome

目的:探讨虚、实证候患者不同部位大肠组织微环境里CAFs主要标志物的差异。方法:制定《结直肠癌中医证候调查表》,对45例受访患者进行一般情况和中医四诊信息的调查。分析常见及新发症状、体征及常见舌脉,患者证候归为虚实两类。用免疫组化方法检测成纤维细胞活化标记物α-平滑肌肌动蛋白(α-SMA)、成纤维细胞激活蛋白(FAP)、成纤维细胞特异蛋白(S100A6)、富含半胱氨酸的酸性分泌蛋白(SPARC)、平足蛋白podoplanin(PDPN)的表达。观察分析它们在结直肠癌患者正常组织、癌旁组织、癌组织表达差异以及中医虚、实辨证表达是否有规律,探讨它们在疾病发生发展过程中的作用。结果:α-SMA、CAF-FAP、CAF-S100A6、CAF-SPARC、CAF-PDPN标记的CAF在虚证患者的癌组织,癌旁组织、正常组织与实证患者的癌组织、癌旁组织、正常组织之间分别进行对比,表达未见明显差异;而每个指标不同部位分别进行比较,癌组织表达明显高于正常组织,与癌旁组织表达差异不明显。结论:结直肠癌癌组织活化成纤维细胞程度高于正常组织,活化成纤维细胞对癌症的形成起到促进作用;中医虚实辨证分析,癌组织、癌旁组织、正常组织中活化成纤维细胞标记物表达差异不明显,对中医个性化医疗仍需多加探索。

Objective： To investigate the main differences of CAFs markers in different parts of the large intestine tissue microenvironment of patients with deficiency or excess syndromes. Methods： Design a survey about syndromes of colorectal cancer and investigate the general information and TCM four diagnostic information of 45 patients. Analyze the common and new symptoms,signs and common tongue pulse,and classify patients’ syndromes into deficiency and excess. Detect the expressions of fibroblast activation markers α- SMA,FAP,S100A6,SPARC and PDPN with immunohistochemistry method. Observe and analyze the differences when they separately express in normal tissue,adjacent tissue and cancerous tissue of patients with colorectal ancer and if there is a regular expression of TCM excess or deficiency syndrome to understand their functions during the occurrence of disease. Results： There is no obvious difference in the expressions of α- SMA,FAP,S100A6,SPARC and PDPN tags in cancer tissue,adjacent tissues and normal tissues between patients with deficiency syndrome and excess syndrome. While comparing all the indexes in different parts,the expression in cancerous tissue is significantly higher than that in normal tissue,and the expression in tissue adjacent to carcinoma shows no obvious difference. Conclusion： The activated fibroblasts in colorectal carcinoma tissue is higher than that in normal tissue and activated fibroblasts accelerate the formation of cancer. According to the actual condition of traditional Chinese medicine syndrome differentiation analysis,the expression of activated fibroblasts marker shows no obvious difference in cancerous tissue,normal tissue and the tissue adjacent to carcinoma. It still need to further explore the personalized medicine of traditional Chinese medicine.