【摘要】 [目的]探讨大肠息肉中医病证与血管内皮生成因子(vascular endothelial growth factor,VEGF)、激酶插入嵌合受体/胎肝激酶-1(kinase insert domain-containing receptor/fetal liver kinase-1,KDR/FLK-1)、微血管密度(microvessel density,MVD)的表达及病理生物学特征的关系。[方法]对148例大肠息肉患者进行中医证型及临床流行病学的研究;采用免疫组织化学方法检测VEGF及KDR在肠息肉组织中的表达水平,计数MVD。[结果]肠息肉分脾胃虚弱、大肠湿热、肝郁气滞、寒邪内阻及血瘀内停5种证型,脾胃虚弱型占41.21%,息肉表现为直径<1.0cm、亚蒂、表面光滑,多见于左半结肠伴直肠,好发于>50岁患者;VEGF、KDR在绒毛状腺瘤、息肉≥2.0cm、息肉表面呈分叶状及年龄>50岁者中表达量高,差异有统计学意义(P<0.05)。[结论]绒毛状腺瘤、息肉>2.0cm、息肉表面呈分叶状及年龄>50岁者,癌变概率高;VEGF、KDR、MVD及其相互作用对促进大肠息肉血管生成及癌变的过程可能起到重要作用;肠息肉脾胃虚弱型比例最高,故息肉预防治疗以健脾为主。更多还原

【Abstract】 [ Objective ] To correlate disease evidence of traditional Chinese medicine(TCM) with pathobiology features and the expression levels of proteins including vascular endothelial growth factor(VEGF),kinase insert domain-containing receptor / fetal liver kinase-1(KDR / FLK-1) and microvessel density(MVD) in colorectal polyps.[ Methods ] TCM syndrome and clinical epidemiology in 148cases of patients with colorectal polyps were studied;and the expression levels of VEGF and KDR and calculate MVD in colorectal polyps were determined by using immunohistochemical technique.[ Results ] Colorectal polyps were classified into 5syndrome types : weakness of the spleen and stomach,dampness-heat of large intestine,stagnation of liver Qi,pathogenic cold resistance and blood stasis.Among them,the type of weakness of 41.21per cent of patients belonged to the spleen and stomach.Moreover,the polyps were less than 1.0 cm in diameter,sub-pedunculated and smooth-faced,which were detecked most frequently in the left hemicolorectal and patients older than 50years.The expression levels of VEGF and KDR were higher in villous adenoma,the polyps larger than 2.0cm in diameter,lobulated polyps and patients older than 50years with statistical significance(P<0.05).[ Conclusion ] Cancerous probability is high in villous adenoma,the polyps more than 2.0cm in diameter,lobulated polyps and patients more than 50years old.VEGF,KDR,MVD and their interactions may play a critical role in promoting the process of angiogenesis and canceration in colorectal polyps.The type of weakness of the spleen and stomach accounted for the highest proportion in colorectal polyps,hence,the prevention and treatment of polyps give priority to strengthen the spleen.更多还原