Clinical Research On The Relationship Between Spleen Deficiency And HSP70 Expression In Gastric Cancer

Objective: To determine the expression of HSP70 in the pathological tissues and serum of gastric cancer patients, and to explore its role in the occurrence and development of gastric cancer. In combination with the theory of Spleen deficiency, to investigate the correlation between the expression level of HSP70 in gastric carcinoma and age,gender, the state of spleen deficiency, tumor location, pathologic type,differentiation grade. HSP70 is expected to be a reference index for predicting gastric mucosal carcinogenesis. To study the difference of clinical data between mild spleen deficiency group and moderate or severe spleen deficiency group in gastric cancer,so as to provide laboratory basis for syndrome differentiation of gastric cancer with spleen deficiency syndrome.Methods: In accordance with the diagnostic criteria and exclusion criteria provided by "Practice of Internal Medicine 14 th Edition",the definitive histological diagnosis of 41 patients with gastric carcinoma admitted were selected. Data were collected from September2014 to November 2015,separately,in Kumming Yan’an Hospital.Following the syndrome standards of spleen deficiency and spleen deficiency symptoms scale score, The experimental group was divided into12 cases of mild spleen deficiency group and 29 cases of moderate and severe spleen deficiency group. At the same time,15 cases of chronic superficial gastritis and19 cases of intraepithelial neoplasia were selected as the control group.HSP70 tissue expressions in 41 cases with of gastric cancer,19 cases of intraepithelial neoplasia and 15 cases of chronic superficial gastritis were determined by immunohistochemistry(ICH). At the same time, The expression level of HSP70 in the serum of the three groups was examined by enzyme-linked immunosorbent assay analysis(ELISA).The clinical information included the patients’ gender,age, personal history, past history, clinical symptoms, blood lipids, blood routine,blood coagulation function, serum protein, tumor markers and spleen deficiency symptoms integral, tumor sites, pathological types, differentiation grade and other examination results,and on the clinical data for statistical analysis.Results:(1)There were 41 cases of gastric cancer patients, a total of 12 patients with mild spleen, accounting for 29.27%, moderate and severe spleen in 29 cases, accounting for70.73%.(2)Compared with mild spleen deficiency group, in moderate and severe spleen deficiency group, red blood cell 、hemoglobin 、total serum protein 、serum albumin、Serum pre albumin levels were decreased;but total cholesterol 、low density lipoprotein、cancer antigen125、cancer antigen 199 levels were elevated;the difference was statistically significant(P<0.05). the difference was statistically significant(P <0.05).(3)Among gastric cancer patients,symptoms of spleen deficiency accumulated points in mild spleen deficiency group were(3.08+0.9)ng/ml, the scores in moderate and severe spleen deficiency group were(8.17+2.33)ng/ml. In spleen deficiency scores,there were significant differences between the two groups(P <0.05).(4)Compared with gastric cancer group with mild spleen deficiency, The expression of serum HSP70 was higher in the moderate and severe spleen deficiency group.(5) The positive results of immunostaining for HSP70 were observed in chronic superficial gastritis, intraepithelial neoplasia and gastric cancer were 20%, 68.42%, 78.05%,respectively.With the development of gastric cancer, the expression level of HSP70 increased.There are significant differences in HSP70 expression level of chronic superficial gastritis,epithelial neoplasia and gastric cancer tissues(Z=19.273, P<0.001).(6) The serum level of HSP70 in intraepithelial neoplasia,chronic superficial gastritis,gastric cancer showed increased expression, The difference between the three groups was statistically significant(P<0.001).(7)There are significant differences in the expression level of HSP70 in gastric cancer patients of different ages(P<0.05), the expression level of serum Hsp70 decreased with increasing age.Serum HSP70 levels were negatively correlated with age((r=-0.322, P=0.040)), and has nothing to do with gender(r=-0.101, P=0.531).(8)Among patients with different stomach neoplasms sites, no significant difference in HSP70 expression existed(P>0.05). the majority of gastric cancer is located in distal stomach, mainly in gastric antrum, there are 19 cases, accounting for 46.34%.(9) Poorly differentiated gastric cancer tissue based, a total of 27 cases of gastric cancer,accounting for 65.85%,Significant differences existed in HSP70 expression levels of the different degree of differentiation of gastric cancer(P <0.05), and expression of HSP70 in serum was gradually increased with the decline in the degree of differentiation. The expression level of HSP70 protein was negatively correlated with the degree of differentiation(r=-0.346, P=0.027).(10) Differences in expression levels of HSP70 with different degrees of spleen deficiency were remarkably significant(P<0.05). The expression of HSP70 increased with the increase of spleen deficiency, the expression level of HSP70 in serum and spleen deficiency was positively correlated(r=0.471, P=0.002).(11) Adenocarcinoma in pathological type of gastric cancer is the most common, a total of 32 cases of adenocarcinoma, accounting for 78.05%. In addition, there are papillary adenocarcinoma, mucinous adenocarcinoma and printed Rong cell cancer.There was no statistical meaning in serum HSP70 expression in distrinct pathological types of gastric carcinoma.( P>0.05).Conclusions:(1) Spleen deficiency is an important factor in the occurrence and development of gastric cancer. It plays an important role in the pathogenesis of gastric cancer. And it plays a guiding role in the assessment of the severity of the disease.(2) Hypoproteinemia, elevated tumor markers are closely related to the severity of spleen deficiency in patients.To a certain extent, these clinical indexes can reveal the essence of spleen deficiency syndrome. Therefore, the abnormal clinical indexes above should be timely adjusted and cured, so as to improve life quality of patients.(3) The expression of HSP70 in pathological tissue and serum in patients with chronic superficial gastritis, intraepithelial neoplasia and gastric cancer was gradually increasing. The level of HSP70 expression were positively correlated with spleen deficiency in gastric cancer,but it was negatively correlated with the age and the degree of histological differentiation,and not correlated with gender, pathological location and pathological types of the patients.HSP70 is expected to be a reference index for predicting gastric mucosal carcinogenesis. The determination of HSP70 expression provides laboratory data for the diagnosis of gastric cancer,and provide objective basis for TCM syndrome differentiation of spleen deficiency,which may be used as a biological marker for judging the severity of gastric cancer with spleen deficiency.And develop a new approach Integrated traditional Chinese and Western medicine in treatment of gastric cancer.