胃癌前病变环氧合酶-2蛋白的表达及中医辨证

Expression of cyclooxygenase-2 and traditional Chinese medical syndrome differentiation and typing in gastric pre-carcinoma

目的 :探讨胃癌前病变中环氧合酶 2蛋白的表达及中医辨证。方法 :采用免疫组织化学方法 ,研究 2 0例慢性胃炎、16例萎缩性胃炎、15例肠上皮化生、19例不典型增生、12例早期胃癌及 2 8例进展期胃癌患者的环氧合酶 2蛋白的表达情况 ,比较各种辨证分型与病理的关系。结果 :环氧合酶 2蛋白在浅表性胃炎、萎缩性胃炎、肠化生、不典型增生、早期胃癌及进展期胃癌中的表达逐渐增强 ;其中肠上皮化生、不典型增生、早期胃癌及进展期胃癌与慢性胃炎相比有显著差异 (P均 <0 .0 1) ;不典型增生与早期胃癌相比无显著差异(P>0 .0 5 ) ,与进展期胃癌相比有显著差异 (P<0 .0 1)。在疾病发展的不同阶段 ,中医辨证不同 ,浅表性胃炎肠上皮化生阶段多属脾胃虚弱型 ,肠上皮化生早期胃癌阶段多属湿热邪毒型 ,进展期胃癌阶段多属气滞血瘀型。结论 :环氧合酶 2蛋白可能参与胃癌的发生发展过程。

Objective: To study the expression of cyclooxygenase-2(COX-2) and traditional Chinese medical syndrome differentiation and typing in gastric pre-carcinoma. Methods: The COX-2 protein were investigated in 20 superficial gastritis,16 atrophic gastritis, 15 intestinal metaplasia, 19 dysplasia, 12 early gastric cancer and 28 advanced gastric cancer by immunohistochemistry. The relation of traditional Chinese medical syndrome differentiation and typing and pathology was compared. Results: COX-2 protein increased gradually in superficial gastritis, atrophic gastritis, intestinal metaplasia, dysplasia, early gastric cancer and advanced gastric cancer. The superficial gastritis expressed COX-2 protein decreased among intestinal metaplasia, dysplasia, early gastric cancer and advanced gastric cancer (all P<0.01). The advanced gastric cancer expressed COX-2 protein stronger than dysplasia(P<0.01), and there was no significant difference both dysplasia and early gastric cancer (P>0.05). The traditional Chinese medical syndrome differentiation and typing vary in gastric precarcinoma. Superficial gastritis and intestinal metaplasia were involved in spleen-stomach deficiency type (脾胃虚弱型), intestinal metaplasia and early gastric cancer were involved in damp-heat and evil toxic type(湿热邪毒型), advanced gastric cancer were involved in Qi stagnant and blood stasis type(气滞血瘀型). Conclusion: The resule of the present study suggests that COX -2 may involve in occurrence of gastric pre-carcinoma and cancer .