胃癌患者中医证型与Hp感染、组织凋亡相关蛋白及预后的相关性分析

Correlation among Traditional Chinese Medicine Syndromes and Hp Infection,Tissue Apoptosis-related Proteins,Prognosis for Patients with Gastric Cancer

目的:分析胃癌患者中医证型与幽门螺杆菌(Hp)感染、组织凋亡相关蛋白及预后的相关性。方法:选取2015年2月~2018年2月我院收治的胃癌患者96例,根据中医辨证分型分为脾胃虚寒型(n=27)、肝胃不和(n=23)、瘀毒内阻(n=25)和痰湿凝结(n=21)。另选择同期行胃镜检查,经病理活检明确诊断为慢性萎缩性胃炎患者48例为对照组。比较胃癌中医症型与患者性别、年龄差异。采用Warthin-Starry银染液法检测患者Hp感染情况。Western blot法检测胃癌中医证型中Survivin、Bax/Bcl-2蛋白表达。结果:胃癌中医证型患者性别、年龄无显著性差异(P>0.05)。观察组Hp阳性检出率明显高于对照组(P<0.05);胃癌中医证型间Hp阳性检出率无明显差异(χ^(2)=2.013,P=0.517)。与肝胃不和证型患者相比,其他组Surviving、Bax/Bcl-2蛋白表达升高(P<0.05)。随访36个月,脾胃虚寒证、肝胃不和证、瘀毒内阻证和痰湿凝结证患者总生存率分别为59.25%、59.25%、73.91%和68.00%。结论:胃癌患者不同中医证型可能处于不同病变发展阶段,在一定程度上可反映胃癌疾病严重程度及预后情况。

Objective:To analyze the correlation among TCM syndromes and Helicobacter pylori(Hp)infection,tissue apoptosis-related proteins,prognosis for patients with gastric cancer.Methods:A total 96 patients with gastric cancer admitted to the hospital were enrolled from February 2015 to February 2018.According to different TCM syndromes,they were divided into spleen-stomach deficiency cold type(n=27),liver-stomach discordance(n=23),blood stagnation-stasis type(n=25)and phlegm-dampness condensation type(n=21).And other 48 patients who were confirmed with chronic atrophic gastritis by pathological and underwent gastroscopy were enrolled as controlled group.The differences in genders and age among patients with different TCM syndromes were compared.Hp infection was detected by Warthin-Starry silver staining solution method.The expressions of Survivin and Bax/Bcl-2 proteinswere detected by Western blot.Results:There was no significant difference in gender or age among patients with different TCM syndromes(P>0.05).The detection rate of Hp positive in the observation group was significantly higher than that the controlled group(P<0.05).There was no significant difference in the detection rate of Hp positive among patients with different TCM syndromes(χ^(2)=2.013,P=0.517).Compared with those patients with liver-stomach discordance type,expressions of Surviving and Bax/Bcl-2 proteins in the other groups were higher(P<0.05).After 36 months of follow-up,the overall survival rates in patients with spleen-stomach deficiency-cold type,liver-stomach discordance type,blood stagnation-stasis type,and phlegm-dampness condensation type were 59.25%,59.25%,73.91%and 68.00%,respectively.Conclusion:The gastric cancer patients with different TCM syndromes may be at different development stages of febrile lesions,which can reflect the severity and prognosis of gastric cancer to a certain extent.