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目的:研究胃癌前病变(Precancerous lesion of gastric cancer,PLGC)虚实关联证患者的癌变趋向及演变规律。方法:多中心临床协作,选择324例PLGC属虚实关联证者进行为期两年的临床跟踪,同步检测血清肿瘤相关物质(tumor supplied group of factors,TSGF)或癌胚抗原(carcino-embryonic antigen,CEA)。结果:324例PLGC患者7类证型中两年内发生癌变29例,癌变率为9%。癌变率最高的证型依次是:湿热藴胃并/兼脾胃虚寒证16.7%,胃络瘀阻并/兼气阴两虚证13.2%,肝胃气滞并/兼脾胃虚寒证8%。TSGF水平高峰值出现在前两类证型上。癌变患者癌变前半年证候呈虚实多证兼夹态势,其虚证涉气血虚、肾虚占48%。结论:PLGC癌变证候具有虚实兼夹的多态性及虚涉气血虚、肾阴阳虚的特征性。
Objective: To study the carcinogenesis and evolution of patients with Precancerous lesion of gastric cancer (PLGC). Methods: In a multicenter clinical trial, 324 cases of PLGC were included in the study. The two patients were followed up for two years. The serum tumor-related substance (TSGF) or carcinoembryonic antigen (CEA) ). Results: There were 29 cases of carcinogenesis in 324 cases of PLGC in 7 years and the rate of carcinogenesis was 9%. Syndromes with the highest rates of cancers were followed as follows: 16.7% of damp and heat stasis stomach and syndrome of deficiency of the spleen and stomach, 13.2% of stomach stasis and / or concurrent deficiency of both qi and Yin, 8% . TSGF level peak appeared in the first two types of syndromes. Cancer patients with cancer before the first half of the syndrome showed a virtual reality and folder posture, the deficiency of Qi involving the blood, kidney accounted for 48%. Conclusion: The cancerous syndromes of PLGC have the characteristics of both virtual reality and occlusion, as well as the features of virtual Qi and blood deficiency and kidney yin and yang deficiency.