进展期胃癌证素特征与胃癌干细胞相关基因CD133、CD44表达间的关系

发布时间：2018-03-08 07:38

本文选题：进展期胃癌　切入点：证素　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对进展期胃癌患者进行证素辨证,研究其证素分布特征,应用免疫组化法测胃癌干细胞相关基因CD133和CD44表达水平,并与癌旁组织相对比,探讨进展期胃癌证素分布特征与胃癌干细胞相关基因CD133、CD44表达间的关系,对探讨胃癌中、西医发病机制及相互间联系提供依据。方法:对60例进展期胃癌患者的四诊资料进行规范化采集,将采集资料进行证素辨证,对所得出的数据进行统计分析,得出进展期胃癌的主要病位、病性证素。同时,收集其60例进展期胃癌患者的癌组织和癌旁正常组织(距癌灶5cm以上),应用免疫组化法(SP法)检测胃癌组织和癌旁组织中胃癌干细胞相关基因CD133和CD44表达水平,进而阐释进展期胃癌证素分布特征与胃癌干细胞相关基因CD133、CD44之间的关系。结果:1.年龄分布特点:以60-69岁多见,男性多于女性,男女比例为3:1。2.证素分布特点:主要病位证素是胃、脾,其次为肝、肾;主要病性证素是气虚,其次为湿、血瘀、气滞、阴虚、实热。3.胃癌组织中CD133、CD44基因表达阳性率分别是41.67%(25/60)、46.67%(28/60),而相应的癌旁组织阳性表达均是0.00%(0/60),得出癌组织CD133、CD44基因表达水平明显高于癌旁组织,差异具有统计学意义(P0.01)。胃癌组织中CD133基因表达水平与患者年龄、性别、肿瘤分期、淋巴结转移及肿瘤发生部位无统计学上意义(P0.05);CD44基因表达水平与淋巴结转移有关(P0.01),与患者年龄、性别、肿瘤分期及肿瘤发生部位无统计学上意义(P0.05)。4.病位证素"胃"、"脾",病性证素"气虚"、"湿"、"血瘀"与胃癌干细胞相关基因CD133、CD44表达水平有相关性(P0.05),而其它证素与胃癌干细胞相关基因CD133、CD44表达水平没有相关性(P0.05)。结论:1.进展期胃癌患者的主要病位证素是胃、脾,其次为肝、肾;病性证素以气虚为主,湿、血瘀、气滞、阴虚、实热、痰也较多见,提示胃癌的发病机制为有虚、有实,以本虚为主,本虚为脾胃气虚为主,实以湿、血瘀、气滞、实热、痰为主。2.胃癌组织CD133、CD44基因阳性表达率明显大于癌旁组织,胃癌组织中CD133基因表达水平与患者年龄、性别、肿瘤分期、淋巴结转移及肿瘤发生部位没有相关性;CD44基因表达水平与淋巴结转移相关,与患者年龄、性别、肿瘤分期及肿瘤发生部位没有相关性。可见CD133、CD44的基因表达水平对进展期胃癌的诊断、CD44的基因表达水平与胃癌转移有重要的意义。3.进展期胃癌的病位证素"胃"、"脾",病性证素"气虚"、"湿"、"血瘀"与胃癌组织CD133、CD44基因表达水平有相关性,提示不同证素之间胃癌组织CD133、CD44基因表达水平是不一致的,对解释胃癌证素微观机制有一定积极意义,更好阐释胃癌中、西医发病机制及二者的联系。
[Abstract]:Objective: to study the distribution of syndromes in patients with advanced gastric cancer by syndrome differentiation, and to detect the expression levels of CD133 and CD44 in gastric cancer stem cell by immunohistochemical method, and to compare them with adjacent tissues. To investigate the relationship between the distribution of syndromes in advanced gastric cancer and the expression of CD133pCD44, a gene related to gastric cancer stem cells, and to explore the relationship between the expression of CD133 and CD44 in gastric cancer. Methods: the data of 60 patients with advanced gastric cancer were collected standardized, the data were identified by syndrome differentiation, and the obtained data were statistically analyzed. At the same time, the main disease location of advanced gastric cancer, disease syndromes, The expression levels of CD133 and CD44 related genes of gastric cancer stem cells in 60 patients with advanced gastric cancer and normal adjacent tissues (more than 5 cm from cancer focus) were detected by immunohistochemical staining (SP method). Results: 1. Age distribution: more than 60-69 years old, male than female, the ratio of male to female is 3: 1.2. The distribution of syndromes: the main symptom factor is stomach. Spleen, liver, kidney, deficiency of qi, dampness, blood stasis, stagnation of qi, deficiency of yin, The positive rates of CD133hCD44 gene expression in gastric cancer tissues were 41.67 and 46.67, respectively, and the corresponding positive expression rates of CD133- CD44 in adjacent tissues were 0.000 / 60. It was found that the expression of CD133 + CD44 gene in cancer tissues was significantly higher than that in paracancerous tissues. There was no statistical significance between the expression of CD133 gene and age, sex, tumor stage, lymph node metastasis and tumor location in gastric carcinoma. Sex, There was no statistical significance in staging and location of tumor. 4. The expression level of syndrome factors "stomach", "spleen", "qi deficiency", "dampness" and "blood stasis" were correlated with the expression level of CD133T CD44, while other syndromes were correlated with gastric cancer dry stem cells. There was no correlation between the expression level of CD133 and CD44. Conclusion: 1. The main locus syndromes of advanced gastric cancer patients is stomach. Spleen, followed by liver and kidney; the disease syndrome is characterized by deficiency of qi, dampness, blood stasis, stagnation of qi, deficiency of yin, heat of solid and phlegm, suggesting that the pathogenesis of gastric cancer is deficiency of stomach, deficiency of essence, deficiency of qi of spleen and stomach, and dampness. Blood stasis, Qi stagnation, solid heat, phlegm. 2. The positive rate of CD133 + CD44 gene in gastric cancer tissue was significantly higher than that in adjacent tissues. The expression level of CD133 gene in gastric cancer tissue was correlated with age, sex, tumor stage. There was no correlation between the expression of CD44 gene and lymph node metastasis, and there was no correlation between the expression of CD44 gene and lymph node metastasis. There is no correlation between tumor staging and tumor location. It can be seen that the expression level of CD133pCD44 gene is of great significance to the diagnosis of advanced gastric cancer and metastasis of gastric cancer .3.The disease site syndromes of advanced gastric cancer "stomach", "spleen", "spleen" "," Qi deficiency "," dampness "and" blood stasis "are correlated with the expression level of CD133T CD44 gene in gastric cancer. It is suggested that the expression of CD133hCD44 gene in gastric cancer tissues is not consistent among different syndromes, which has a positive significance in explaining the microscopic mechanism of gastric cancer syndromes, and better explains the pathogenesis of gastric cancer in western medicine and the relationship between them.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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