| Background:Gastrointestinal polyps a common and frequently occurring disease, which has close relationship with tumors of the gastrointestinal tract.With the popularity of electronic endoscope, the detection rate is increasing. Gastrointestinal polyps have been recognized as precancerous lesions,yet it’s not clear of the occurrence and development of gastrointestinal polyps and cancerous mechanism. The current research of gastrointestinal polyps at home and abroad stays in their endoscopic observation, treatment and pathological features, but be lack of a systematic and comprehensive observation.Meanwhile, reported cause of gastrointestinal polyps and TCM Syndrome involves less.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 gastrointestinal polyps.Methods:To study TCM syndrome and clinical epidemiology in148cases of patients with intestinal polyps and150cases of gastric polyps; to determine the expression levels of VEGF and KDR and calculate MVD in intestinal polyps by using by immunohistochemical technique. Statistical analysis the data with SPSS16.0, test at P<0.05was statistically significant.Results:1. The type of weakness of the spleen is most frequently in intestinal polyps, which accounted for41.21. Followed by the order is dampness-heat of large intestine syndrome in40cases (27.03%), stagnation of liver Qi in23cases (15.54%), pathogenic cold internal resistance in17cases (11.49%), blood stasis within the stop in7cases (4.73%).Moreover, the polyps are less than1.0cm in diameter, sub-pedunculated and smooth-faced, which are seen most frequently in left hemi-colon and patients older than50years. The most common pathological type is adenomatous polyps.2. The pathogenesis of gastric polyps mainly in spleen, which accounted for49.33%, including Stomach Deficiency syndrome in55cases (36.67%), liver depression and spleen deficiency syndrome in19cases (12.67%). Followed by the order is Qi stagnation and phlegm obstruction in60cases (40%), heat and phlegm stagnation syndrome in14cases (9.33%), blood stasis within the stop2cases (1.33%).They are usually less than lcm in length, accounted for88, and are found primarily in the antrum and body of the stomach. It forms with sessile and smooth surface. The most frequently pathological type is inflammatory polyps, which accounted for71.33%.3. The gastrointestinal polyps may be due to smoking and alcohol, genetic factors, dietary factors, social factors, long-term medication and distribution of TCM constitution type.The risk factors of intestinal polyps is long-term medication, and the risk factors of gastric polyps mainly for social factor and dietary factor.In Chinese medical practitioners, gastiric polyps mainly related to Qi deficiency, phlegm, and intestinal polyps were associated mainly with Qi deficiency, dampness-heat.4. Frequency of clinical symptoms in patients with intestinal polyps is descending order, which as change in bowel habits, abdominal pain, blood in the stool, diarrhea, bloating, constipation, and among the change in bowel habits, change in stool frequency and character is main. Frequency of gastric polyps in patients with clinical symptoms is descending order as stomach pain, belching, bloating, acid reflux, nausea, vomiting, loss of appetite, and about61.3%with two or more symptoms.5. Intestinal polyps occur in males, and gastric polyps occur in females.In terms of the average age if onset, intestinal polyps was significantly higher than that of gastric polyps, both of which occurred in patients over50years old; with the age increase,TCM syndromes were from virtual to real transformation trend.6. The expression of VEGF, KDR and MVD from weak or no expression gradually increase to strong expression in normal mucosa, gastrointestinal polyps and cancer tissue, particularly strong expression in the cancer tissue. 7. The expression levels of VEGF and KDR in intestinal polyps are high in villous adenoma, the polyps larger than2.0cm in diameter, lobulated polyps and patients older than50years with statistical significance (P<0.01)8. The expression levels of VEGF and KDR in gastric polyps are high in inflammatory polyps, the polyps larger than2.0cm in diameter with statistical significance (P<0.01),and high in pedunculated polyps and patients older than50years without statistical significance (P>0.05)9. The expression levels of VEGF、KDR and MVD in intestinal polyps are higher than in gastric polyps, which has statistical significance. The expression levels of VEGF and KDR in gastrointestinal polyps is positively correlated.Conclusions:Angiogenesis is already occurred before tumor ormatted. Cancerous probability is high in the polyps more than2.0cm in diameter and patients more than50years old in gastrointestinal polyps. Cancerous probability is high in intestinal polyps more than in gastric polyps, especially in the polyps villous adenoma and lobulated polyps. VEGF, KDR, MVD and their interactions may play a critical role in promoting the process of angiogenesis and canceration in gastrointestinal polyps. Therefore, we should pay attention for such polyps by biopsy and excision. The pathogenesis of the gastrointestinal polyps is the vacuity, and the type of weakness of the spleen and the stomach accounted for the highest proportion, so the prevention and treatment of polyps give priority to strengthening the spleen. The gastric polyps were focus on soothing liver to relieve depression and resolving phlegm, and the intestinal polyps were focus on clearing heat and drying dampness. |
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