结直肠癌中医证型及微卫星不稳定性研究  

Study on TCM Syndrome Types and Microsatellite Instability of Colorectal Cancer

作　　者：林天碧[1] 章学林[1] 陈骏毅 侯佳伟 LIN Tian-bi;ZHANG Xue-lin;CHEN Jun-yi;HOU Jia-wei(l.Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Shanghai Fouth People's Hospital,Shanghai 200081,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海市第四人民医院,上海200081

出　　处：《中医药导报》2019年第20期32-35,共4页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：上海中医药大学附属龙华医院科技创新项目(CX201728)

摘　　要：目的:分析结直肠癌的中医证型分布规律及微卫星不稳定性(MSI)结直肠癌的临床特征,探讨二者之间是否存在关联。方法:回顾性分析109例结直肠癌患者,运用免疫组化检测法进行微卫星不稳定性的判定,并根据指南进行中医辨证和病理诊断。结果:109例结直肠癌患者中,男女比例为1∶0.63,年龄(68.55±11.21)岁。其中12例(11.0%)患者为MSI,右半结肠占58.3%,而在微卫星稳定(MSS)组中,右半结肠占26.8%。脾虚气滞47例(43.1%)、湿热蕴结12例(11.0%)、瘀毒内阻8例(7.3%)、脾肾阳虚6例(5.5%)、肝肾阴虚4例(3.7%)和气血两虚32例(29.4%)。微卫星状态与各中医证型之间无明显关联。结论:MSI结直肠癌的发生率约为11.0%。MSI肿瘤更好发于右半结肠,而在其他方面未发现明显差异。结直肠癌的中医证型以脾虚气滞证为主,微卫星状态与各中医证型之间无明显关联。Objective: To analyze the distribution of TCM syndromes of colorectal cancer and the clinical characteristics of microsatellite instability(MSI) colorectal cancer, and to explore whether there is a correlation between them. Methods: A retrospective analysis of 109 patients with colorectal cancer was carried out. Microsatellite instability was determined by immunohistochemical method. TCM syndrome differentiation and pathological diagnosis were made according to the guidelines. Results: Among 109 patients with colorectal cancer, the ratio of male to female was 1:0.63, and the average age was(68.55 ±11.21) years. Among them, 12 patients(11.0%) had MSI, and the right colon accounted for 58.3%, while the right colon accounted for 26.8% in MSS group. 47 cases of spleen vacuity Qi stagnation(43.1%), 12 cases of damp-heat brewing and binding(11.0%), 8 cases of static toxin causing internal obstruction(7.3%), 6 cases(5.5%) of spleen and kidney yang deficiency, 4 cases(3.7%) of liver and kidney yin deficiency and 32 cases(29.4%) of Qi and blood deficiency. There was no significant correlation between microsatellite instability and TCM syndromes. Conclusion: The incidence of MSI colorectal cancer is approximately 11.0%. MSI colorectal cancers were more likely to occur in the right colon, but no significant difference was found in other aspects. The main TCM syndromes of colorectal cancer were spleen vacuity Qi stagnation. There was no significant correlation between microsatellite status and TCM syndrome types.

关 键 词：结直肠癌 中医证型 微卫星不稳定性 回顾性研究 

分 类 号：R273[医药卫生—中西医结合]