自拟中药汤剂对幽门螺杆菌相关性胃癌前病变患者胃黏膜Ki-67蛋白表达的影响
|
摘要
目的 分析自拟中药汤剂对幽门螺杆菌(Hp)相关性胃癌前病变患者胃黏膜Ki-67蛋白表达的影响,为感染相关性疾病的治疗和控制提供研究依据。方法 选取医院2015年1月-2018年1月收治的268例Hp相关性胃癌前病变患者作为研究对象,应用随机数字表法将其分为研究组和对照组,每组各134例。对照组患者在三联Hp根除治疗基础上给予胃康灵胶囊进行治疗,研究组患者在三联Hp根除治疗基础上给予自拟中药汤剂进行治疗。对两组患者治疗前、后胃黏膜病理评分、Ki-67蛋白表达阳性率进行检测和比较。观察两组患者临床疗效和Hp根除率。结果 治疗后,研究组患者胃黏膜不完全型肠化、异型增生的病理评分降低值大于对照组(P<0.05)。研究组疗效优于对照组(P=0.023)。研究组患者Hp根除率为87.31%(117/134)高于对照组的69.40%(93/134)(P<0.001)。两组患者的胃黏膜Ki-67蛋白表达阳性率均较治疗前下降,研究组患者治疗后的胃黏膜Ki-67蛋白表达阳性率低于对照组,差异有统计学意义(P<0.001)。结论 在三联Hp根除治疗的基础上应用自拟中药汤剂进行辅助治疗,能够显著改善患者的临床症状和胃黏膜病理变化程度、提高Hp根除率、降低Ki-67蛋白表达阳性率,对于抑制胃黏膜病变进展、降低胃癌发生率具有积极的意义。
OBJECTIVE To observe the influence of self-draft traditional Chinese medicine decoction on expression of Ki-67 protein in gastric mucosa of patients with Helicobacter pylori(Hp)-associated precancerous lesions of gastric cancer so as to provide guidance for treatment and control of the infection-related diseases. METHODS A total of 268 patients with Hp-associated precancerous lesions of gastric cancer who were treated in the hospital from Jan 2015 to Jan 2018 were recruited as the study objects and randomly divided into the study group and the control group, with 134 cases in each group.The control group was treated with Wei Kang Ling Capsule on the basis of the triple Hp eradication treatment, while the study group was given the self-draft traditional Chinese medicine decoction on the basis of the triple Hp eradication treatment.The pathological score of gastric mucosa and positive rate of expression of Ki-67 protein were detected and compared between the two groups of patients before and after the treatment, and the clinical curative effects and eradication rate of Hp were observed and compared between the two groups of patients. RESULTS The reduced value of pathological value of incomplete intestinal metaplasia and dysplasia of gastric mucosa was significantly greater in the study group than in the control group after the treatment(P<0.05); the curative effect of the study group was significantly better than that of the control group(P=0.023).The eradication rate of Hp of the study group was 87.31%(117/134), significantly higher than 69.40%(93/134) of the control group(P<0.001).The positive rate of expression of Ki-67 protein in gastric mucosa of the two groups of patients was significantly lower after the treatment than before the treatment, and the positive rate of expression of Ki-67 protein in gastric mucosa of the study group was significantly lower than that of the control group after the treatment(P<0.001). CONCLUSION The triple Hp eradication treatment combined with self-draft traditional Chinese medicine decoction can significantly improve the clinical symptoms and degree of pathological change of gastric mucosa, raise the eradication rate of Hp and reduce the positive rate of expression of Ki-67 protein, and it has positive significance in inhibiting the progression of gastric mucosa lesions and reducing the incidence of gastric cancer.
OBJECTIVE To observe the influence of self-draft traditional Chinese medicine decoction on expression of Ki-67 protein in gastric mucosa of patients with Helicobacter pylori(Hp)-associated precancerous lesions of gastric cancer so as to provide guidance for treatment and control of the infection-related diseases. METHODS A total of 268 patients with Hp-associated precancerous lesions of gastric cancer who were treated in the hospital from Jan 2015 to Jan 2018 were recruited as the study objects and randomly divided into the study group and the control group, with 134 cases in each group.The control group was treated with Wei Kang Ling Capsule on the basis of the triple Hp eradication treatment, while the study group was given the self-draft traditional Chinese medicine decoction on the basis of the triple Hp eradication treatment.The pathological score of gastric mucosa and positive rate of expression of Ki-67 protein were detected and compared between the two groups of patients before and after the treatment, and the clinical curative effects and eradication rate of Hp were observed and compared between the two groups of patients. RESULTS The reduced value of pathological value of incomplete intestinal metaplasia and dysplasia of gastric mucosa was significantly greater in the study group than in the control group after the treatment(P<0.05); the curative effect of the study group was significantly better than that of the control group(P=0.023).The eradication rate of Hp of the study group was 87.31%(117/134), significantly higher than 69.40%(93/134) of the control group(P<0.001).The positive rate of expression of Ki-67 protein in gastric mucosa of the two groups of patients was significantly lower after the treatment than before the treatment, and the positive rate of expression of Ki-67 protein in gastric mucosa of the study group was significantly lower than that of the control group after the treatment(P<0.001). CONCLUSION The triple Hp eradication treatment combined with self-draft traditional Chinese medicine decoction can significantly improve the clinical symptoms and degree of pathological change of gastric mucosa, raise the eradication rate of Hp and reduce the positive rate of expression of Ki-67 protein, and it has positive significance in inhibiting the progression of gastric mucosa lesions and reducing the incidence of gastric cancer.
引文
[1] Chen KB,Chen J,Jin XL,et al.Exosome-mediated peritoneal dissemination in gastric cancer and its clinical applications[J].Biomed Rep,2018,8(6):503-509.
[2] Choi YY,Cho M,Kwon IG,et al.Ten thousand consecutive gastrectomies for gastric cancer:perspectives of a master surgeon[J].Yonsei Med J,2019,60(3):235-242.
[3] Natsugoe S,Arigami T,Uenosono Y,et al.Novel surgical approach based on the sentinel node concept in patients with early gastriccancer[J].Ann Gastroenterol Surg,2017,1(3):180-185.
[4] Li H,Feng LQ,Bian YY,et al.Comparison of endoscopic submucosal dissection with surgical gastrectomy for early gastriccancer:An updated meta-analysis[J].World J Gastrointest Oncol,2019,11(2):161-171.
[5] 刘长旭,刘昶,纪艳超.量子点荧光腹腔镜在胃癌治疗中的研究进展及前景[J].中国微创外科杂志,2018,18(3):271-273.
[6] 崔瑶,李剑,曹养辉,等.高敏感格拉斯哥评分对进展期胃癌患者新辅助化疗疗效和预后的预测作用[J].中华肿瘤杂志,2017,39(3):195-200.
[7] Shichijo S,Hirata Y.Characteristics and predictors of gastric cancer after Helicobacter pylori eradication[J].World J Gastroenterol,2018,24(20):2163-2172.
[8] Wu JY,Lee YC,Graham DY.The eradication of Helicobacter pylori to prevent gastric cancer:a critical appraisal[J].Expert Rev Gastroenterol Hepatol,2019,13(1):17-24.
[9] 吴艳芳,李静,赵兴丽,等.幽门螺杆菌感染患者继续动机性访谈对遵医依从性的影响[J].中华医院感染学杂志,2017,27(17):3917-3920.
[10] 曹广文.我国恶性肿瘤防治研究和实践需要技术、管理和观念的创新[J].中华流行病学杂志,2017,38(1):3-12.
[11] 中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2013,8(1):24-36.
[12] 中华医学会消化病分会幽门螺杆菌学组.第四次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2012,17(10):832-837.
[13] 中华中医药学会脾胃病分会.慢性萎缩性胃炎中医诊疗共识意见(2009,深圳)[J].中国中西医结合消化杂志,2010,18(5):345-349.
[14] Cheung KS,Leung WK.Modification of gastric cancer risk associated with proton pump inhibitors by aspirin afterHelicobacter pylori eradication[J].Oncotarget,2018,9(97):36891-36893.
[15] 林钟宇,潘华峰,赵金媛,等.健脾化瘀解毒法对胃癌前病变的作用机制研究进展[J].中华中医药杂志,2016,31(7):2706-2708.
[16] 张德英,侯卓成,李卫强.中医药治疗胃癌前病变研究进展[J].辽宁中医杂志,2016,43(1):207-210.
[17] 宋晨雪,王昱博,刘传贵,等.传统中药联合标准三联疗法治疗幽门螺杆菌诱发的慢性非萎缩性胃炎及其作用机制[J].吉林大学学报(医学版),2016,42(4):789-792.
[18] Yuan X,Liu D,Wang Y,et al.Significance of nuclear magnetic resonance combined with Ki-67 and VEGF detection in the diagnosis and prognosis evaluation of brain glioma[J].J BUON,2018,23(2):410-415.
[19] Calik M,Demirci E,Altun E,et al.Clinicopathological importance of Ki-67,p27,and p53 expression in gastric cancer[J].Turk J Med Sci,2015,45(1):118-128.
[20] Arima N,Nishimura R,Osako T,et al.Ki-67 index value and progesterone receptor status can predict prognosis and suitable treatmentin node-negative breast cancer patients with estrogen receptor-positive and HER2-negativetumors[J].Oncol Lett,2019,17(1):616-622.
[2] Choi YY,Cho M,Kwon IG,et al.Ten thousand consecutive gastrectomies for gastric cancer:perspectives of a master surgeon[J].Yonsei Med J,2019,60(3):235-242.
[3] Natsugoe S,Arigami T,Uenosono Y,et al.Novel surgical approach based on the sentinel node concept in patients with early gastriccancer[J].Ann Gastroenterol Surg,2017,1(3):180-185.
[4] Li H,Feng LQ,Bian YY,et al.Comparison of endoscopic submucosal dissection with surgical gastrectomy for early gastriccancer:An updated meta-analysis[J].World J Gastrointest Oncol,2019,11(2):161-171.
[5] 刘长旭,刘昶,纪艳超.量子点荧光腹腔镜在胃癌治疗中的研究进展及前景[J].中国微创外科杂志,2018,18(3):271-273.
[6] 崔瑶,李剑,曹养辉,等.高敏感格拉斯哥评分对进展期胃癌患者新辅助化疗疗效和预后的预测作用[J].中华肿瘤杂志,2017,39(3):195-200.
[7] Shichijo S,Hirata Y.Characteristics and predictors of gastric cancer after Helicobacter pylori eradication[J].World J Gastroenterol,2018,24(20):2163-2172.
[8] Wu JY,Lee YC,Graham DY.The eradication of Helicobacter pylori to prevent gastric cancer:a critical appraisal[J].Expert Rev Gastroenterol Hepatol,2019,13(1):17-24.
[9] 吴艳芳,李静,赵兴丽,等.幽门螺杆菌感染患者继续动机性访谈对遵医依从性的影响[J].中华医院感染学杂志,2017,27(17):3917-3920.
[10] 曹广文.我国恶性肿瘤防治研究和实践需要技术、管理和观念的创新[J].中华流行病学杂志,2017,38(1):3-12.
[11] 中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2013,8(1):24-36.
[12] 中华医学会消化病分会幽门螺杆菌学组.第四次全国幽门螺杆菌感染处理共识报告[J].中华内科杂志,2012,17(10):832-837.
[13] 中华中医药学会脾胃病分会.慢性萎缩性胃炎中医诊疗共识意见(2009,深圳)[J].中国中西医结合消化杂志,2010,18(5):345-349.
[14] Cheung KS,Leung WK.Modification of gastric cancer risk associated with proton pump inhibitors by aspirin afterHelicobacter pylori eradication[J].Oncotarget,2018,9(97):36891-36893.
[15] 林钟宇,潘华峰,赵金媛,等.健脾化瘀解毒法对胃癌前病变的作用机制研究进展[J].中华中医药杂志,2016,31(7):2706-2708.
[16] 张德英,侯卓成,李卫强.中医药治疗胃癌前病变研究进展[J].辽宁中医杂志,2016,43(1):207-210.
[17] 宋晨雪,王昱博,刘传贵,等.传统中药联合标准三联疗法治疗幽门螺杆菌诱发的慢性非萎缩性胃炎及其作用机制[J].吉林大学学报(医学版),2016,42(4):789-792.
[18] Yuan X,Liu D,Wang Y,et al.Significance of nuclear magnetic resonance combined with Ki-67 and VEGF detection in the diagnosis and prognosis evaluation of brain glioma[J].J BUON,2018,23(2):410-415.
[19] Calik M,Demirci E,Altun E,et al.Clinicopathological importance of Ki-67,p27,and p53 expression in gastric cancer[J].Turk J Med Sci,2015,45(1):118-128.
[20] Arima N,Nishimura R,Osako T,et al.Ki-67 index value and progesterone receptor status can predict prognosis and suitable treatmentin node-negative breast cancer patients with estrogen receptor-positive and HER2-negativetumors[J].Oncol Lett,2019,17(1):616-622.