河南科技大学学报（医学版）
河南科技大學學報（醫學版）
하남과기대학학보（의학판）
JOURNAL OF HENAN UNIVERSITY OF SCIENCE & TECHNOLOGY(MEDICAL SCIENCE)
2015年
2期
90-92,96
,共4页
苏秀丽%金建军%邢鲁奇
囌秀麗%金建軍%邢魯奇
소수려%금건군%형로기
胃复春%维甲酸%胃癌癌前病变%抑癌基因Rb%癌基因C-erbB-2
胃複春%維甲痠%胃癌癌前病變%抑癌基因Rb%癌基因C-erbB-2
위복춘%유갑산%위암암전병변%억암기인Rb%암기인C-erbB-2
Weifuchun tablets%Retinoic Acid tablet%precancerous lesions of gastric carcinoma%tumor suppressor genes Rb%oncogene C-erbB-2
目的：观察胃复春联合维甲酸治疗胃癌癌前病变的疗效及对 Rb、C-erbB-2表达的影响，探讨二者干预胃癌癌前病变进展的可能机制，为胃癌的二级预防提供理论依据。方法通过胃镜活检、病理检查确诊获取异型增生（dysplasia，Dys）伴或不伴胃黏膜肠化（intestinal metaplasia，IM）122例，随机分为治疗组63例，对照组59例。治疗组用药为维甲酸、胃复春；对照组用药为奥美拉唑、硫糖铝。服药3月后再次由胃镜活检获取病理标本，采用免疫组化法检测治疗前后 Rb、C-erbB-2表达情况。结果服药3个月后，治疗组有效率68．25％，对照组37．29％相比较有统计学意义（P ＜0．05）；能上调 Rb 表达强度（U ＝2．543，P ＜0．05），下调 C-erbB-2的表达（U ＝3．032，P ＜0．05），与对照组相比，差别有统计学意义（P ＜0．05），临床观察胃复春联合维甲酸无明显毒、副作用。结论胃复春联合维甲酸可促进胃黏膜异型增生的逆转，降低癌变风险，可能的作用机制之一是上调抑癌基因 Rb 的表达、下调癌基因 C-erbB-2的表达，可用作胃癌的预防治疗。
目的：觀察胃複春聯閤維甲痠治療胃癌癌前病變的療效及對 Rb、C-erbB-2錶達的影響，探討二者榦預胃癌癌前病變進展的可能機製，為胃癌的二級預防提供理論依據。方法通過胃鏡活檢、病理檢查確診穫取異型增生（dysplasia，Dys）伴或不伴胃黏膜腸化（intestinal metaplasia，IM）122例，隨機分為治療組63例，對照組59例。治療組用藥為維甲痠、胃複春；對照組用藥為奧美拉唑、硫糖鋁。服藥3月後再次由胃鏡活檢穫取病理標本，採用免疫組化法檢測治療前後 Rb、C-erbB-2錶達情況。結果服藥3箇月後，治療組有效率68．25％，對照組37．29％相比較有統計學意義（P ＜0．05）；能上調 Rb 錶達彊度（U ＝2．543，P ＜0．05），下調 C-erbB-2的錶達（U ＝3．032，P ＜0．05），與對照組相比，差彆有統計學意義（P ＜0．05），臨床觀察胃複春聯閤維甲痠無明顯毒、副作用。結論胃複春聯閤維甲痠可促進胃黏膜異型增生的逆轉，降低癌變風險，可能的作用機製之一是上調抑癌基因 Rb 的錶達、下調癌基因 C-erbB-2的錶達，可用作胃癌的預防治療。
목적：관찰위복춘연합유갑산치료위암암전병변적료효급대 Rb、C-erbB-2표체적영향，탐토이자간예위암암전병변진전적가능궤제，위위암적이급예방제공이론의거。방법통과위경활검、병리검사학진획취이형증생（dysplasia，Dys）반혹불반위점막장화（intestinal metaplasia，IM）122례，수궤분위치료조63례，대조조59례。치료조용약위유갑산、위복춘；대조조용약위오미랍서、류당려。복약3월후재차유위경활검획취병리표본，채용면역조화법검측치료전후 Rb、C-erbB-2표체정황。결과복약3개월후，치료조유효솔68．25％，대조조37．29％상비교유통계학의의（P ＜0．05）；능상조 Rb 표체강도（U ＝2．543，P ＜0．05），하조 C-erbB-2적표체（U ＝3．032，P ＜0．05），여대조조상비，차별유통계학의의（P ＜0．05），림상관찰위복춘연합유갑산무명현독、부작용。결론위복춘연합유갑산가촉진위점막이형증생적역전，강저암변풍험，가능적작용궤제지일시상조억암기인 Rb 적표체、하조암기인 C-erbB-2적표체，가용작위암적예방치료。
Objective To investigate the effect of the Weifuchun tablets with combination Retinoic Acid tablet on gastric precancerous lesions and its regulative effect on the expression of the Rb gene and the C-erbB-2 gene. Methods One hundred and twenty-two patients with gastroscopy and pathology confirmed dysplasia(DYS)with or without intestinal metaplasia(IM)were classified randomly into treatment group and control group .The treatment group consisting of 63 patients was treated with a Weifuchun tablets,Retinoic Acid tablet,Omeprazole tablet and Sucralfate tablet.The other 59 patients were treated with Sucralfate tablet and Omeprazole tablet as control.Rb and C-erbB-2 protein were detected by the immunohistochemical method before and after the treatment. Results Compared with the control group 37.29% of effective power,the treatment group 68.25% was significantly improved after three months of treatment (P <0.05 ).The abnormal expression of the Rb Gene and the C-erbB-2 Gene was found in both groups and effectly regulated by Weifuchun tablets and Retinoic Acid tablet. Conclusion The combination of Weifuchun tablets and Retinoic Acid tablet was effective in treating gastric dysplasia and intestinal metaplasia.It could reduce the risk of carcinogenesis of gastric precancerous lesions by reversing the gastric mucosa lesions and regulating the expression of tumor suppressor genes Rb,oncogene C-erbB-2.The combination of Weifuchun tablets and Retinoic Acid tablet could effectly be used in the treatment of precancerous lesions.
