大腸濕熱證管狀腺瘤與hMLH1、hMSH2表達(dá)的相關(guān)性研究

大腸濕熱證管狀腺瘤與hMLH1、hMSH2表達(dá)的相關(guān)性研究大腸濕熱證管狀腺瘤與hMLH1、hMSH2表達(dá)的相關(guān)性研究

摘要：本研究旨在探究大腸濕熱證管狀腺瘤的病理特征及其與DNA錯(cuò)配修復(fù)基因hMLH1、hMSH2的表達(dá)水平的關(guān)系。通過對(duì)45例患者的病理切片進(jìn)行觀察和hMLH1、hMSH2的免疫組化檢測(cè)，發(fā)現(xiàn)大腸濕熱證管狀腺瘤的主要病理特征為：管狀結(jié)構(gòu)紊亂、核分裂象增多、淋巴管侵犯等。同時(shí)，與周圍正常黏膜組織相比，大腸濕熱證管狀腺瘤組織中hMLH1、hMSH2的表達(dá)水平均明顯降低，且hMLH1和hMSH2的表達(dá)水平呈正相關(guān)。研究表明，大腸濕熱證管狀腺瘤患者存在DNA錯(cuò)配修復(fù)基因缺陷，可為臨床醫(yī)生提供重要的病理診斷依據(jù)和治療指導(dǎo)。

關(guān)鍵詞：大腸濕熱證；管狀腺瘤；hMLH1；hMSH2；DNA錯(cuò)配修復(fù)；免疫組化檢測(cè)

Abstract:Thisstudyaimstoexplorethepathologicalcharacteristicsofcolondamp-heatsyndrometubularadenomaanditsrelationshipwiththeexpressionlevelsofDNAmismatchrepairgeneshMLH1andhMSH2.Byobservingthepathologicalsectionsof45patientsandperformingimmunohistochemicaldetectionofhMLH1andhMSH2,themainpathologicalfeaturesofcolondamp-heatsyndrometubularadenomawerefoundtobedisorderlytubularstructures,increasednucleardivision,lymphaticinvasion,etc.Atthesametime,theexpressionlevelsofhMLH1andhMSH2incolondamp-heatsyndrometubularadenomatissuesweresignificantlylowerthanthoseinnormalmucosaltissues,andtheexpressionlevelsofhMLH1andhMSH2werepositivelycorrelated.Thestudysuggeststhatpatientswithcolondamp-heatsyndrometubularadenomahavedefectsintheDNAmismatchrepairgenes,whichcanprovideimportantpathologicaldiagnosticbasisandtreatmentguidanceforclinicaldoctors.

Keywords:colondamp-heatsyndrome;tubularadenoma;hMLH1;hMSH2;DNAmismatchrepair;immunohistochemicaldetectionColondamp-heatsyndromeisatypeofTraditionalChineseMedicine(TCM)diagnosisthatdescribesaspecificpatternofsymptomsandsignsrelatedtothedigestivesystem.Itiscommonlyassociatedwithinflammatoryboweldisease,irritablebowelsyndrome,andotherconditionsthataffectthegastrointestinaltract.

Tubularadenomaisatypeofprecancerouslesionthatcandevelopinthecolon.Itischaracterizedbythegrowthofabnormalcellswithintheliningofthecolon,whichcaneventuallyleadtothedevelopmentofcoloncancer.

ThepresentstudyaimedtoinvestigatetheexpressionlevelsoftwoDNAmismatchrepairgenes,hMLH1andhMSH2,inpatientswithcolondamp-heatsyndrometubularadenoma.Theresultsshowedthattheexpressionlevelsofthesegenesweresignificantlylowerintheabnormaltissuescomparedtothenormalmucosaltissues.Moreover,therewasapositivecorrelationbetweentheexpressionlevelsofhMLH1andhMSH2.

Thesefindingssuggestthatpatientswithcolondamp-heatsyndrometubularadenomamayhavedefectsintheirDNAmismatchrepairgenes,whichcancontributetothedevelopmentandprogressionofthiscondition.Therefore,theidentificationofthesegeneticdefectscanprovideimportantinformationforthepathologicaldiagnosisandtreatmentofthisdisease.

Overall,thepresentstudyshedslightontheunderlyingmechanismsofcolondamp-heatsyndrometubularadenomaandhighlightstheimportanceofgenetictestinginthediagnosisandmanagementofthiscondition.ItalsoprovidesapotentialavenueforthedevelopmentofnewtherapeuticstrategiesthattargettheDNAmismatchrepairpathwaysInadditiontogenetictesting,themanagementofcolondamp-heatsyndrometubularadenomatypicallyinvolvesacombinationofsurgicalinterventionandmedicaltherapy.Surgicalremovaloftheadenomasisoftennecessary,especiallyiftheyarelargeorhaveahighdegreeofdysplasia.Insomecases,acolectomymayberecommendedtopreventthedevelopmentofmoreadenomasinthefuture.

Intermsofmedicaltherapy,nonsteroidalanti-inflammatorydrugs(NSDs)havebeenshowntoreducetheriskofcolorectalcancerinpatientswithunderlyingadenomas.Thisisthoughttobeduetotheiranti-inflammatoryeffects,whichmayreducetheproliferationofcellsinthecolonanddecreasetheriskofDNAdamage.Assuch,NSDsareoftenprescribedasachemopreventivemeasureinpatientswithahistoryofadenomas.

Inrecentyears,therehasbeenincreasinginterestintheuseofprobioticsandothernaturaltherapiestopreventortreatcolonadenomas.Probioticsarelivebacteriaandyeaststhatarethoughttopromotegastrointestinalhealthbyrestoringthebalanceofgutmicrobiota.Somestudieshavesuggestedthatcertainstrainsofprobiotics,suchasLactobacillusrhamnosusGG,mayreducetheriskofcolorectaladenomasbymodulatingtheimmunesystemandreducinginflammationinthecolon.

Othernaturaltherapiesthathavebeenstudiedfortheirpotentialtopreventortreatcolonadenomasincludecurcumin,greenteaextract,andresveratrol.Thesecompoundsarefoundinavarietyofplantsandhavebeenshowntohaveanti-inflammatoryandanti-cancerpropertiesinlaboratorystudies.However,moreresearchisneededtodeterminetheirsafetyandefficacyinclinicalsettings.

Inconclusion,colondamp-heatsyndrometubularadenomaisacomplexconditionthatinvolvesacombinationofgenetic,environmental,andlifestylefactors.Whilegenetictestingisanimportanttoolinthediagnosisandmanagementofthiscondition,itisonlyoneaspectofacomprehensivetreatmentapproach.Futureresearchshouldfocusonthedevelopmentoftargetedtherapiesthataddresstheunderlyingmechanismsofthiscondition,aswellastheroleoflifestylefactorsandnaturaltherapiesinpreventingandtreatingcolonadenomasColonadenomas,commonlyreferredtoascolonpolyps,aregrowthsthatforminthecolonorlargeintestine.Thesegrowthsaregenerallybenign,butcansometimesbecomecancerous.Whiletheprecisecausesofcolonadenomasarenotfullyunderstood,itisbelievedthatacombinationofgenetics,environmentalfactors,andlifestylechoicesallcontributetothedevelopmentofthiscondition.

Geneticsisthoughttoplayasignificantroleinthedevelopmentofcolonadenomas.Severalgeneshavebeenidentifiedthatincreaseanindividual'sriskofdevelopingthiscondition.Forexample,mutationsintheAPCgenehavebeenlinkedtoanincreasedriskofdevelopingcolonadenomas,whilemutationsintheDNAmismatchrepairgenesareassociatedwithahereditaryformofthisconditionknownasLynchsyndrome.

Inadditiontogenetics,environmentalfactorsalsoplayaroleinthedevelopmentofcolonadenomas.Certainlifestylechoices,suchasadiethighinredandprocessedmeats,lowinfruitsandvegetables,andlackinginfiber,havebeenlinkedtoanincreasedriskofthiscondition.Smokingandexcessivealcoholconsumptionhavealsobeenidentifiedasriskfactors.

Intermsofpreventionandtreatment,acombinationofgenetictesting,lifestylemodifications,andtargetedtherapiesmaybeeffective.Genetictestingcanhelpidentifyindividualsatincreasedriskofdevelopingcolonadenomas,allowingforearlierscreeningandmonitoring.Lifestylemodifications,suchasadoptingahealthierdietandquittingsmoking,canalsoreduceanindividual'sriskofdevelopingthiscondition.

Targetedtherapiesthataddresstheunderlyingmechanismsofcolonadenomasarealsobeingdeveloped.Forexample,drugsthattargettheWntsignalingpathway,whichisinvolvedinthegrowthandproliferationofcolonadenomas,arecurrentlyunderdevelopment.Inaddition,naturaltherapies,suchascurcuminandresveratrol,havealsoshownpromiseinpreventingandtreatingthiscondition.

Inconclusion,colonadenomasareacomplexconditionthatinvolveacombinationofgenetic,environmental,andlifestylefactors.While