1. 上海中医药大学附属曙光医院肿瘤科、肿瘤研究所,上海,201203
2. 上海中医药大学附属市中医医院肿瘤科,上海,200071
3. 上海市第一人民医院中医科,上海,200080
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周利红, 伏杰, 隋华, 等. 大肠癌血瘀证与非血瘀证患者血液流变学指标及促血管生成相关因子表达的差异性研究[J]. 上海中医药杂志, 2019,53(5):25-30.
ZHOU Lihong, FU Jie, SUI Hua, et al. Differences in hemorheological indicators and expression of pro-angiogenic factors between blood stasis syndrome and non-blood stasis syndrome in patients with colorectal cancer[J]. Shanghai Journal of Traditional Chinese Medicine, 2019,53(5):25-30.
周利红, 伏杰, 隋华, 等. 大肠癌血瘀证与非血瘀证患者血液流变学指标及促血管生成相关因子表达的差异性研究[J]. 上海中医药杂志, 2019,53(5):25-30. DOI: 10.16305/j.1007-1334.2019.05.006.
ZHOU Lihong, FU Jie, SUI Hua, et al. Differences in hemorheological indicators and expression of pro-angiogenic factors between blood stasis syndrome and non-blood stasis syndrome in patients with colorectal cancer[J]. Shanghai Journal of Traditional Chinese Medicine, 2019,53(5):25-30. DOI: 10.16305/j.1007-1334.2019.05.006.
目的:通过检测大肠癌血瘀证与非血瘀证患者血液流变学指标和促血管生成相关因子的表达水平,分析血瘀证与血液高凝状态、肿瘤血管新生之间的关系。 方法:将839例(包括回顾性与前瞻性病例)临床大肠癌患者分为血瘀证组与非血瘀证组,采用血浆分离技术检测患者血液中的血液流变学指标并分析各项指标的变化情况,采用蛋白芯片技术检测患者血清中促血管生成相关因子(Angiogenin、ANG-2、EGF、bFGF、HB-EGF、HGF、Leptin、PDGF-BB、PIGF、VEGF)的表达情况并分析其中的差异表达。 结果:①总体上,大肠癌患者中血瘀证与非血瘀证的比例约为1∶4。②大肠癌患者术前血瘀证组男性及女性的红细胞沉降率、血沉方程K值均明显高于正常值,且明显高于非血瘀证组男性及女性的相应水平(P<0.05)。同时,术后红细胞沉降率、血沉方程K值也呈现一致的变化,血瘀证组男性及女性的相应水平明显高于非血瘀证组(P<0.05)。③术前血瘀证组男性及女性的纤维蛋白原水平均明显高于非血瘀证组男性及女性的相应水平(P<0.05);术后血瘀证组、非血瘀证组的男性及女性的纤维蛋白原水平均在正常范围内,组间差异无统计学意义(P>0.05)。④大肠癌血瘀证组患者的血清Angiogenin、ANG-2、EGF、bFGF、HB-EGF、HGF、Leptin、PDGF-BB、PIGF、VEGF表达水平明显高于非血瘀证组(P<0.05)。 结论:与非血瘀证患者相比,大肠癌血瘀证患者血液呈高凝状态,血清促血管生成相关因子的表达明显更高,提示中医血瘀证与肿瘤血管新生之间的关系密切。
Objective:To detect the hemorheological indicators and expression of pro-angiogenic factors in blood stasis syndrome and non-blood stasis syndrome of patients with colorectal cancer (CRC), and analyze the relationship between blood stasis syndrome and blood hypercoagulability as well as tumor angiogenesis. Methods839 patients including retrospective and prospective cases were assigned into blood stasis syndrome group and non-blood stasis syndrome group. The hemorheological indicators in the whole blood of the patients were measured by plasma separation technique, and the changes of these indicators were analyzed. The expression of pro-angiogenic factors (Angiogenin, ANG-2, EGF, bFGF, HB-EGF, HGF, Leptin, PDGF-BB, PIGF and VEGF) in serum was detected by protein chip technique, and differences in expression were analyzed. Results:①In general, the proportion of patients with blood stasis syndrome and non-blood stasis syndrome was about 1∶4 in CRC patients. ②The preoperative erythrocyte sedimentation rate and K value of blood sedimentation equation in the blood stasis syndrome group were significantly higher than normal value in both male and female patients, and were also significantly higher than the corresponding levels in the non-blood stasis syndrome group (P<0.05). Meanwhile, the post-operative erythrocyte sedimentation rate and K value of blood sedimentation equation also presented consistent changes, and the corresponding levels of males and females in the blood stasis syndrome group were significantly higher than those in the non- blood stasis syndrome group (P<0.05). ③The average fibrinogen level of males and females in the blood stasis syndrome group was significantly higher than that in the non-blood stasis syndrome group in preoperative CRC patients (P<0.05). The post-operative fibrinogen levels of males and females in both groups were within the normal range on average, with no statistically significant differences between the groups (P>0.05). ④The expression levels of Angiogenin, Ang-2, EGF, bFGF, HB-EGF, HGF, Leptin, PDGF-BB, PIGF and VEGF in serum were significantly higher in the blood stasis syndrome group than in the non-blood stasis syndrome group in CRC patients (P<0.05). Conclusion:Compared to CRC patients with non-blood stasis syndrome, those with blood stasis syndrome showed a high coagulation state, and the expression of pro-angiogenic factors was significantly higher, suggesting a close relationship between blood stasis syndrome in traditional Chinese medicine and tumor angiogenesis in western medicine.
大肠癌血瘀证促血管生成相关因子血液流变学血管新生中医证型活血化瘀
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