【摘要】 目的探讨青海不同海拔地区胃癌中医证型与抗Hp抗体、VEGF、mtP53表达水平之间的关系。方法选择青海不同海拔地区(西宁、格尔木、果洛)胃癌患者进行中医辩证分型。同时对各型患者进行血清抗Hp抗体、血清VEGF水平及胃粘膜mtP53蛋白表达水平测定,并行相关分析。结果不同海拔地区胃癌患者抗Hp抗体阳性表达率:西宁地区36.67%,格尔木地区40.00%,果洛地区66.67%,西宁地区、格尔木地区两地抗Hp抗体阳性表达率低于果洛地区(P<0.01);mtP53阳性表达率:西宁地区40.00%,格尔木地区50.00%,果洛地区53.33%,三地区之间无显著性差异(P>0.05);患者血清VEGF水平:果洛地区患者高于西宁地区和格尔木地区患者(P<0.05)。各证型之间比较:抗Hp抗体的阳性表达率,脾胃虚寒型、痰湿阻胃型患者明显高于肝胃不和、气滞血瘀和胃阴亏虚型(P<0.01);mtP53的阳性表达率,脾胃虚寒、气滞血瘀、痰湿阻胃型患者明显高于肝胃不和型和胃阴亏虚型(P<0.05);患者的VEGF水平脾胃虚寒型明显高于其他四型(P<0.01,P<0.05);痰湿阻胃型VEGF水平明显高于气滞血瘀、肝胃不和、胃阴亏虚型(P<0.01,P<0.05)。脾胃虚寒证、肝胃不和证及痰湿阻胃证患者抗Hp抗体、mtP53呈正相关性。结论青海地区胃癌生成和中医证候存在相关性,胃癌患者幽门螺杆菌的感染、血清VEGF的表达及P53基因的突变与中医证型有关,提示高海拔、缺氧环境可影响胃癌发生因素。更多还原

【Abstract】 Objective To Explore the relation between the level of Anti-Hp antibody,VEGF and mtP53 expression in patients with Gastric Cancer classified by TCM method,from different altitude in Qinghai Province.Methods Selected gastric cancer patients from different high altitude region(Xining,Golmud,Guoluo)and divided them into various types using TCM syndrome differentiation.At the same time,We measured the serum level of anti-Hp antibody、VEGF levels and mutant P53 protein in gastric mucosa.and conducted the correlation study among them.Results The Anti-Hp antibody positive expression rate in gastric cancer in Xining was 36.67%,40.00% in Golmud,and 66.67% in Guoluo,respectively.The anti-Hp antibody-positive expression rate Patients from Xining and Golmud was lower than Patients from Guoluo(P<0.01).The positive expression level of mtP53 in Xining was 40.00%,50.00%(Golmud) and 53.33%(Guoluo),respectively.There were no significant difference among the patients from the three different places(P>0.05).Compared with the Gastric cancer patients from Xining and Golmud,patients from Guoluo had the higtest serum level of VEGF(P<0.05).Compare the the different type of TCM syndromes of Gastric cancer,the anti-Hp antibody positive expression rate in Spleen Deficiency type,Phlegm and Damp Blocking the stomach type were significantly higher than the positive expression rate of anti-Hp antibody in Liver stomach disharmony type,Qi stagnancy and Blood stasis type and Stomach Yin Deficiency type(P<0.01).However,the mtP53 positive expression rate in Spleen Deficiency type,Qi stagnancy and Blood stasis type and Phlegm and Damp Blocking the stomach type were obviously higher than Incoordination between Liver and Stomach type and Stomach Yin Deficiency type(P<0.05).VEGF levels in patients with Spleen Deficiency type was significantly higher than the other four types(P<0.01,P<0.05).the expression level of anti-Hp antibody and mtP53 in patients of IN Spleen Deficiency type、Incoordination between Liver and Stomach type and Phlegm and Damp Blocking the stomach type were positively correlated.Conclusion The results of this study suggest that the development of Gastric cancer in different altitudes area were Positively correlated with TCM syndromes.Hp infection、serum VEGF levels and mtP53 gene mutations related to TCM syndrome in Gastric cancer patients,which indicate that high altitude,hypoxia environment may influence the gastric cancer risk factors.更多还原