EGFR在鼻咽癌临床分期中作用及与中医证型关系初探  

A study on the effect of EGFR in the clinical stages of NPC and the relationship of EGFR with the TCM syndrome type

作　　者：李湘 颜文杰 夏纪严[2] 

机构地区：[1]广东省中西医结合医院耳鼻咽喉科(广东佛山南海区中医院),528200 [2]广东省中医院

出　　处：《中国中西医结合耳鼻咽喉科杂志》2012年第6期413-417,442,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：广东省医学科学技术研究基金(A2008235)

摘　　要：目的探讨EGFR与鼻咽癌临床病理特征的相关性并初探其与中医证型的关系。方法利用免疫组织化学二步法检测不同中医证型鼻咽癌组织60例及慢性鼻咽炎组织20例中EGFR的表达情况,结果经IPP6.O进行图像分析。结果 EGFR在鼻咽癌组织中的表达明显高于慢性鼻咽炎组织(P=0.003<0.1);Ⅰ期与Ⅱ期鼻咽癌患者病理组织MOD(EGFR)之间无显著性差异(P=0.381>0.05),其他组间都存在显著性差异,随着临床分期的升高,MOD(EGF、R)逐渐增大。鼻咽癌组织EGFR的表达与T分期相关,而与N分期无关;初诊鼻咽癌以痰浊结聚证(48.3%)及气血凝结证(40.0%)多见。痰浊结聚证与火毒困结证之间MOD(EGFR)无显著性差异(p=0.659>0.05),但气血凝结证患者MOD(EGFR)明显高于痰浊结聚证及火毒困结证患者。结论在鼻咽癌组织中存在EGFR的高表达,EGFR表达可能与肿瘤细胞增殖活性密切相关,鼻咽病理组织中EGFR的免疫组化测定作为一种常规检测应用于临床具有一定的推广应用价值。气血凝结证鼻咽癌患者的预后可能较痰浊结聚及火毒困结证患者差。Objective To investigate the relevance of EGFR and the clinical pathological features of NPC（nasopharyngeal carcinoma） and the relationship with the TCM syndrome type.Methods Tissues of 60 nasopharyngeal carcinomas with different TCM syndrome type and of 20 chronic nasopharyngitis were examined by immunohistochemistry. Microscopic image analysis was used by IPP 6.0.Results： EGFR expression in NPC was significantly higher than in chronic nasopharyngitis tissues （P=-〈0.005）. There was no significant difference between NPC patients in the Phase I and II（P〉0.05）. In other groups significant differences could be observed. MOD （EGFR） was gradually increasing with higher clinical stage. EGFR expression was significantly related to T staging, but not to N staging. Two TCM syndrome types could be mainly recognized in the first diagnosis, phlegm syndrome（including 48.3%） and blood stasis syndrome（including 38.3%）. The MOD （EGFR） of phlegm syndrome and heat-toxin syndrome presented no significant difference （P=0.659〉 0.05）, but the MOD （EGFR） in the blood stasis syndrome was significantly higher than in the phlegm syndrome and heat-toxin syndrome.Conclusion The nasopharyngeal carcinoma showed high expression of EGFR, EGFR expression may be closely related to proliferation of tumor cell; Immunohistochemical determination of EGFR in nasal pharyngeal tissue could be helpful in NPC diagnosis.Blood stasis syndrome patients may have worse prognosis than phlegm syndrome and heat-toxin syndrome.

关 键 词：鼻咽癌 中医证型 表皮生长因子受体 免疫组织化学 显微图像分析 

分 类 号：R739.63[医药卫生—肿瘤]