胃癌及胃癌前病变患者中医证型与病理及Hp感染的关系  

The relationship between TCM_bianzheng, pathology and Hp infection in patients with gastric carcinoma and its precancerous lesions

作　　者：张万岱[1] 谢国建[1] 杨海涛[1] 周殿元[1] 

机构地区：[1]第一军医大学南方医院全军消化内科研究所

出　　处：《新消化病学杂志》1997年第9期564-566,共3页

摘　　要：目的研究胃癌及胃癌前病变患者中医分型与病理组织学及Ｈｐ感染的关系．方法选取资料完整的慢性胃病患者之病理及临床资料２０３例进行中医分型、Ｈｐ检测和ＰＣＮＡ染色，对胃癌前病变（ｎ＝１３４）胃癌（ｎ＝３３）及对照组（浅表性胃炎，ｎ＝３６）等各组进行比较分析．结果中医分型与病理改变有一定的相关性，在浅表性胃炎中以寒热夹杂型为主，胃癌及胃癌前病变中以脾胃虚寒为主，而寒热夹杂型较少，在胃癌及胃癌前病变患者中未发现Ｈｐ感染与中医分型有明显关系，胃癌及癌前病变组Ｈｐ感染率（６２４％，６６７％～７９８％）明显高于对照组（３４１％），且发病年龄Ｈｐ阳性者明显低于Ｈｐ阴性者（４９９％ｖｓ５６７，４６１～５３８ｖｓ５３８～６２０，Ｐ＜００５），ＰＣＮＡＬＩ随病变程度的加重而升高（γ＝０９５１，Ｐ＜００２５）．结论Ｈｐ感染与胃癌及胃癌前病变的发生有密切关系．AIM To study the relationship between TCM_bianzheng, gastric pathohistology and Helicobacter pylori (Hp) infection in patients with gastric carcinoma (GC) and its precancerous lesions (PL). METHODS Chronic gastropathy ( n =203), typed by TCM_bianzheng, were diagnosed histologically. Hp status was identified by Warthin_Starry or Giemsa stain. The specimens were also examined with PCNA immunohistologically. The patients ( n =36) with superficial gastritis served as controls, and were compared with those with GC ( n =33) and with gastric PL ( n =134). RESULTS There was certain correlation between TCM_bianzheng typing and pathology. Most of the patients with chronic gastritis had a mixed cold and heat syndromes (MCH), whereas those with GC and with PL were largely classified as Piwei Xu_Cold (PWXC), only a few were classified as MCH. There were no significant relations between Hp infection and TCM_typing in those with GC and precancerous lesions. The Hp infection rate was higher in patients with GC and its PL (62 4%, 66 7%～79 8%) when compared with the control (34 1%). The onset was earlier in those with positive Hp than with negative Hp (49 9 vs 56 7 in GC group, 46 1～53 8 vs 53 8～62 0 in PL group, P <0 05). PCNA LI was increased with the deterioration of malignant diseases (γ=0 951, P <0 025). CONCLUSION It is suggested that Hp infection is strongly correlated with the pathogenesis of GC and its PL. PCNA LI could be used as a quantitative index to evaluate the degree of gastric mucosal lesions.

关 键 词：胃肿瘤 癌 癌前状态 中医证型 幽门螺杆菌 感染 

分 类 号：R735.202[医药卫生—肿瘤]