摘要
目的 探讨胃癌中医辨证分型与细胞增殖活性、抑癌基因、癌基因的关系 ,为胃癌中医辨证本质研究以及中西医结合治疗提供线索或指导。方法 观察 6 2例胃癌病人 ,根据中医辨证标准分型 ;并设正常对照组 31例。检测它们PCNA表达 ;抑癌基因P53 失活、过表达 ;癌基因C erbB 2激活、过表达的变化及与中医辨证分型的关系。结果 胃癌虚、实证病人其胃癌组织中PCNA表达显著升高、P53 基因表达显著升高、C erbB 2基因显著升高 (P均 <0 0 1) ;胃癌虚证与实证比较 ,虚证更为显著 (P <0 0 5或P <0 0 1)。结论 抑癌基因失活 ,癌基因激活是引起胃癌发病的主要原因之一 ,抑癌基因失活是正气衰弱的表现 ,癌基因激活是邪气亢实的表现 ,PCNA则是胃癌局部正邪相搏的表现形式 ,胃癌的不同阶段PCNA、癌基因、抑癌基因表达不同 ,晚期即中医虚证阶段表现更为显著。在基因水平体现了胃癌正衰邪盛、本虚标实的病因病机。促进抑制基因活性 ,抑制癌基因激活的“促正抑邪”
Objective To investigate the relationship between syndrome differentiation of traditiond chinese medicin(TCM) and PCNA,P 53 gene and C erbB 2 gene in gastric carcinoma,to find some evidence for the objective differentiation of TCM or treatment of combination TCM and western medicine in gastric carcinnoma.Methods 62 patients with gastric carcinoma,of which one half belong to deficiency syndrome and the other half belong to sthenia syndrome,were studied by using immunohistochemical methods compared with 31 normal persons.Results PCNA of P 53 gene and C erbB 2 gene in gastric carcinoma were higher than those in normal persons(P<0.01).Compared with TCM sthenia syndrome,PCNA the expression of P 53 gene,C erbB 2 gene were higer(P<0 05 or P<0 01) TCM deficiency syndrome.Conclusion PCNA may reflect evils of TCM is gastric carcinoma,the abnormal expression of oncogene and suppressor genes is the main factor in gastric carcinoma.The depletion of suppressor genes reflects deficiency of vital energy in TCM and the activation of oncogene reflects sthenia of evils in TCM.The result may provide authentic premise for treating gastric carcinoma by using TCM and eaestern medicine.
关键词
胃癌
中医证型
细胞增殖活性
癌基因
抑癌基因
Gastric carcinoma Deficiency syndrome Sthenia syndrome PCNA P 53 gene C erbB 2 gene