鼻咽癌中医证型与其临床分期和分化程度的关系

Correlation between TCM Syndrome and the Clinical Stage and the Differentiation Degree of Nasopharyngeal Carcinoma

目的分析鼻咽癌中医证型与其临床分期和分化程度的关系。方法选取经病理组织学确诊的初治鼻咽癌患者98例,辨证分为肺热壅盛型、气滞痰凝型、瘀血阻络型及阴虚火旺型四种,经Spearman相关性分析其与临床分期和分化程度的关系。结果①国际抗癌联盟(UICC 2010)分期Ⅰ期+Ⅱ期肺热壅盛型及气滞痰凝型比例高于Ⅲ期+Ⅳ期比例,Ⅰ期+Ⅱ期瘀血阻络型及阴虚火旺型比例低于Ⅲ期+Ⅳ期比例(P <0.01)。②低分化癌和未分化癌之间的辨证分型比较无统计学差异(P>0.05)。③Spearman相关性分析显示,鼻咽癌临床分期与肺热壅盛型及气滞痰凝型呈负相关(rs=-0.331、-0.449, P <0.05),与瘀血阻络型及阴虚火旺型呈正相关(rs=0.399、 0.350, P <0.05);鼻咽癌中医证型与其分化程度无相关性。结论鼻咽癌中医证型与其临床分期具有相关性,而与分化程度无相关性。

Objective To analyze the correlation between TCM syndrome and the clinical stage and the differentiation degree of nasopharyngeal carcinoma(NPC).Methods 98 cases of patients diagnosed by histopathology with initial treatment of NPC were classified into 4 types(the lung heat congestion type,the qi stagnation and phlegm coagulation type,the static blood blocking collaterals type,the yin-deficiency and fire-excess type)according to TCM syndrome differentiation.The correlation between TCM syndrome and the clinical stage and the differentiation degree was analyzed by Spearman.Results①The proportion of the International Anti-Cancer Union(UICC 2010)stageⅠ+stageⅡlung heat congestion type,and qi stagnation and phlegm coagulation type was higher than that of stageⅢ+stageⅣ,the proportion of stageⅠ+stageⅡstatic blood blocking collaterals type,and yin-deficiency and fire-excess type was lower than that of stageⅢ+stageⅣ(P<0.01).②No statistical difference was found in the syndrome differentiation between poorly differentiated and undifferentiated carcinomas(P>0.05).③Spearman correlation analysis showed that the NPC clinical stage was negatively correlated with the lung heat congestion type,and qi stagnation and phlegm coagulation type(r s=-0.331 and-0.449,P<0.05),and was positively correlated with static blood blocking collaterals type,and yin-deficiency and fire-excess type(r s=0.399 and 0.350,P<0.05).TCM syndromes of NPC had no correlation with the differentiation degree.Conclusions NPC TCM syndromes are correlated with clinical stage,but not correlated with differentiation degree.