Preliminary Study On TCM Syndromes And Pathological Features Of Iaryngeal Precancerous Lesion

ObjectiveExplore the characteristics of laryngeal precancerous lesion TCM syndromes and its related pathological features, to provide guidance for clinical TCM syndrome differentiation treatment of laryngeal precancerous.MethodsBase on literature research, using cross-sectional method to studied the informations of90laryngeal precancerous lesion cases, using100vocal cord polyp cases and40laryngeal cancer cases as control study, the preliminary result draw the distribution characteristics of clinical laryngeal precancerous lesion TCM syndromes. Use immunohistochemistry technology; take CyclinDl, CDK4, P16and Rb as research index. Take phlegm stagnation syndrome, heat syndrome and deficiency syndrome of laryngeal precancerous lesion specimens each10cases as experimental group, take30vocal cord polyps and30laryngeal cancer specimens as control study, to analysis the characteristics of laryngeal precancerous lesion TCM syndromes and related pathological features.Results1. The investigation results:(1) The clinical investigation showed that precancerous laryngeal lesions mainly concentrated in the age of50-60years old; there are more males than females in gender composition. Smoking and alcoholism are significant factors of precancerous laryngeal lesions. The occurrence frequency of dry throat in clinical symptoms was55.6%, which compared with vocal cord polyp and laryngeal cancer groups had statistically significant (respectively x2=45.50, P=0.00and χ2=10.40, P=0.001).(2) The general situation of TCM syndromes in this investigation:blood stasis and turbid phlegm factor which including Qi stagnation and blood stasis, turbid phlegm and phlegm stagnation syndrome, are the mainly syndrome factors in vocal cord polyps, precancerous laryngeal lesions and laryngeal cancer, the proportions were respectively88%,52%and60%. The proportion of heat syndrome in precancerous lesion was40%, which compared with laryngeal cancer had no statistical significance (χ2=3.75, P=0.0053), but compared with vocal cord polyps had statistical significance (χ2=25.1, P=0.00). The excessive use of sound factor took the proportion in Qi stagnation and blood stasis syndrome of laryngeal precancerous lesion was49%, while the proportions of smoking, alcoholism factor in heat syndrome were65%and57.9%, those factors in group comparisons had statistically significant (P<0.05).2. The experimental results:(1) The positive expressions of CyclinDl and CDK4had a progressive increase from vocal cord polyps, laryngeal precancerous lesion to laryngeal cancer (respectively10%,37%,60%and23%,30%,60%), while P16and Rb had a diminishing gradient phenomenon from vocal cord polyps, laryngeal precancerous lesion to laryngeal cancer (respectively80%,57%,40%and77%,47%,27%), those positive expressions in group comparison had statistically significant (P<0.01). The positive expressions of CyclinDl, CDK4, P16and Rb are varieties with atypical hyperplasia progression in precancerous laryngeal lesions, but there were no statistical significance(P>0.05).(2) The positive expression of P16in laryngeal precancerous lesion had reach90%in deficient syndrome, which had statistically significant while compared with heat syndrome and phlegm stagnation syndrome groups (χ2=5.51, P=0.01). But the positive expression of CyclinDl, CDK4and Rb in TCM syndrome types showed no statistical significance(P>0.05).(3) Deficient syndrome had the proportion of63.6%in mild dysplasia of precancerous laryngeal lesions, which had statistical significance while compared with heat syndrome (χ2=7.08, P=0.008), but it showed no statistical significance while compared with phlegm stagnation syndrome (χ2=2.93, P=0.08). Heat syndrome had the proportion of75%in moderate dysplasia of precancerous laryngeal lesion, it had statistical significance compared with deficient syndrome and phlegm stagnation syndrome (respectively χ2=4.01, P=0.04and χ2=9.60, P=0.002). TCM syndrome types in severe atypical hyperplasia showed no statistical significance (x2=1.09, P=0.58). Conclusion1. Blood stasis and turbid phlegm factor which including Qi stagnation and blood stasis, turbid phlegm and phlegm stagnation syndrome, are the mainly syndrome factors in precancerous laryngeal lesions. Heat syndrome might be a prominent TCM syndrome in laryngeal precancerous lesion.2. CyclinDl, CDK4, P16and Rb showed positive expression on laryngeal precancerous lesion, and certain correlation between those immunological markers and laryngeal precancerosis dysplasia had been indicated.