本文選題：進(jìn)展期胃癌　切入點(diǎn)：證素　出處：《福建中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過對(duì)進(jìn)展期胃癌患者進(jìn)行證素辨證,研究其證素分布特征,應(yīng)用免疫組化法測(cè)胃癌干細(xì)胞相關(guān)基因CD133和CD44表達(dá)水平,并與癌旁組織相對(duì)比,探討進(jìn)展期胃癌證素分布特征與胃癌干細(xì)胞相關(guān)基因CD133、CD44表達(dá)間的關(guān)系,對(duì)探討胃癌中、西醫(yī)發(fā)病機(jī)制及相互間聯(lián)系提供依據(jù)。方法:對(duì)60例進(jìn)展期胃癌患者的四診資料進(jìn)行規(guī)范化采集,將采集資料進(jìn)行證素辨證,對(duì)所得出的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,得出進(jìn)展期胃癌的主要病位、病性證素。同時(shí),收集其60例進(jìn)展期胃癌患者的癌組織和癌旁正常組織(距癌灶5cm以上),應(yīng)用免疫組化法(SP法)檢測(cè)胃癌組織和癌旁組織中胃癌干細(xì)胞相關(guān)基因CD133和CD44表達(dá)水平,進(jìn)而闡釋進(jìn)展期胃癌證素分布特征與胃癌干細(xì)胞相關(guān)基因CD133、CD44之間的關(guān)系。結(jié)果:1.年齡分布特點(diǎn):以60-69歲多見,男性多于女性,男女比例為3:1。2.證素分布特點(diǎn):主要病位證素是胃、脾,其次為肝、腎;主要病性證素是氣虛,其次為濕、血瘀、氣滯、陰虛、實(shí)熱。3.胃癌組織中CD133、CD44基因表達(dá)陽性率分別是41.67%(25/60)、46.67%(28/60),而相應(yīng)的癌旁組織陽性表達(dá)均是0.00%(0/60),得出癌組織CD133、CD44基因表達(dá)水平明顯高于癌旁組織,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。胃癌組織中CD133基因表達(dá)水平與患者年齡、性別、腫瘤分期、淋巴結(jié)轉(zhuǎn)移及腫瘤發(fā)生部位無統(tǒng)計(jì)學(xué)上意義(P0.05);CD44基因表達(dá)水平與淋巴結(jié)轉(zhuǎn)移有關(guān)(P0.01),與患者年齡、性別、腫瘤分期及腫瘤發(fā)生部位無統(tǒng)計(jì)學(xué)上意義(P0.05)。4.病位證素"胃"、"脾",病性證素"氣虛"、"濕"、"血瘀"與胃癌干細(xì)胞相關(guān)基因CD133、CD44表達(dá)水平有相關(guān)性(P0.05),而其它證素與胃癌干細(xì)胞相關(guān)基因CD133、CD44表達(dá)水平?jīng)]有相關(guān)性(P0.05)。結(jié)論:1.進(jìn)展期胃癌患者的主要病位證素是胃、脾,其次為肝、腎;病性證素以氣虛為主,濕、血瘀、氣滯、陰虛、實(shí)熱、痰也較多見,提示胃癌的發(fā)病機(jī)制為有虛、有實(shí),以本虛為主,本虛為脾胃氣虛為主,實(shí)以濕、血瘀、氣滯、實(shí)熱、痰為主。2.胃癌組織CD133、CD44基因陽性表達(dá)率明顯大于癌旁組織,胃癌組織中CD133基因表達(dá)水平與患者年齡、性別、腫瘤分期、淋巴結(jié)轉(zhuǎn)移及腫瘤發(fā)生部位沒有相關(guān)性;CD44基因表達(dá)水平與淋巴結(jié)轉(zhuǎn)移相關(guān),與患者年齡、性別、腫瘤分期及腫瘤發(fā)生部位沒有相關(guān)性�？梢奀D133、CD44的基因表達(dá)水平對(duì)進(jìn)展期胃癌的診斷、CD44的基因表達(dá)水平與胃癌轉(zhuǎn)移有重要的意義。3.進(jìn)展期胃癌的病位證素"胃"、"脾",病性證素"氣虛"、"濕"、"血瘀"與胃癌組織CD133、CD44基因表達(dá)水平有相關(guān)性,提示不同證素之間胃癌組織CD133、CD44基因表達(dá)水平是不一致的,對(duì)解釋胃癌證素微觀機(jī)制有一定積極意義,更好闡釋胃癌中、西醫(yī)發(fā)病機(jī)制及二者的聯(lián)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.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.2

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