肝癌转移与中医脏象理论相关性的回顾性研究

Retrospective Study on the Connection Between Liver Cancer Metastasis and TCM Theory of Visceral Manifestation

目的:探讨肝癌转移与中医脏象理论的相关性。方法:采用回顾性研究方法,以50例原发性肝癌患者为研究对象,根据中医脏象理论分为4型,记录患者肝癌转移情况与转移部位,并进行相关性分析。结果:50例患者中,肝肾阴虚型20例,肝胆湿热型10例,气滞血瘀型10例,脾虚湿困型10例,转移率分别为40.0%、50.0%、40.0%和40.0%,转移率各证型间比较,差异无统计学意义(P>0.05);肝癌主要转移部位(可合并):脑转移10例,淋巴结转移14例,肺转移6例,骨转移8例,不同证型肝癌转移部位比较,差异也无统计学意义(P>0.05)。在肝癌转移患者中,E-钙黏素(E-cadherin)、血管内皮生长因子(VEGF)、Thy-1、CD34、CK-7的阳性表达与中医证型无明显相关性(P>0.05)。结论:肝癌转移多为淋巴结转移与脑转移,可伴随有E-cadherin、VEGF、Thy-1、CD34、CK-7表达异常,但是与中医脏象理论的相关性还有待进一步分析。

Objective: To explore the connection between liver cancer metastasis and TCM theory of visceral manifestation. Methods: In a retrospective study, fifty patients with primary liver cancer were chosen as the objects of study and divided into four types according to TCM theory of visceral manifestation, the conditions of liver cancer metastasis and metastasis sites were recorded, and the connections were analyzed. Results: Among 50 patients, there were 20 cases of liver-kidney Yin-deficiency pattern, 10 cases of liver-gallbladder dampness-heat pattern, 10 cases of Oi-stagnation and blood stasis pattern and 10 cases of dampness stagnancy due to spleen-deficiency, the metastasis rates were 40.0%, 50.0%, 40.0% and 40.0%, the difference had no statistical meaning in different patterns(P>0.05);the main metastasis sites of liver cancer(which could merge): 10 cases of cerebral metastasis, 14 cases of lymphatic metastasis, six cases of lung metastasis, eight cases of bone metastasis, the difference had no statistical meaning in the comparisons of liver cancer metastasis sites among different patterns(P>0.05). Among the patients with liver cancer metastasis, positive expressions of E-cadherin, VEGF, Thy-1, CD34 and CK-7 showed no obvious correlation with TCM syndromes(P>0.05). Conclusion: Liver cancer metastasis is mostly lymphatic metastasis and cerebral metastasis, accompanying the abnormal expressions of E-cadherin, VEGF, Thy-1, CD34 and CK-7, while its connection with TCM theory of visceral manifestation still needs further analysis.