Based On The Theory Of Collaterals Disease Effects Of Vegf And Mvd, Lvd Relevance To Endometrial Cancer Research

Objective:Endometrial carcinoma (EC) is one of the common female malignant tumors in female reproductive duct. Statistical data have shown that incidence of EC is getting more common while onset age are getting much younger. In some countries, the incidence of endometrial carcinoma lines the first in female malignant tumors. Recent years, epidemiological studies have found that5%of EC patients were und-er40years old, and19%were under45. With the prolonging human average life, the influence of EC to female life quality and healthy is much more remarkable than ever. There are two pathological types in EC. Typel has a slow progression and better therapeutic effect. Early detection and early therapy could significantly promote life quality and survival time. How to improve the early detection, early therapy and prognosis prediction of EC had already became a Imminent problem for gynecologist, and could have remarkable influnce to EC patient as well.Most of TCM research in EC were focused on the therapy method,as well as the effective medicines and their monomers, especially on the adjuvant therapy; few were interest in TCM sydromes types; none in TCM pathogenesis. After the documents systematization and theoretical probe in "TCM Collateral Disease" theory, considering the characteristic of blood supply and metabolism in EC, combined with female pathological and physiological characteristic; we conclude the pathogenesis of EC as "Deficiency and stagnation in uterine collaterals""Uterine collaterals injured by toxins"."The masses obstruction of collaterals " A retrospective research was hold in218cases with endometrial hyperplasia diseases and EC, to analyze and summarize the distribution of TCM syndromes. A research was hold in47cases of endometrial atypical hyperplasia and EC diagnosed by pathology. After detecting the tissue level of VEGF、MVD、LVD, we evaluate and analyze their expression in pathological tissue to find their relativity with TCM syndromes and provide the experimental basis on "TCM Collateral Disease"; explore the correlation between the value of MVD. LVD and clinical stages、histological grade、myometrial invasion condition.Methods:1. Documents systematization and theoretical probe: Document Retrieval using "TCM collateral disease theory"、"collateral disease"、"collateral"、"tumor"、"cancer/carcinoma"、"Gynecology""uterine collateral" as key words, summarize the pathophysiological changes of EC in TCM collateral disease theory.2. To analyze and summarize the distribution of TCM syndromes, a retrospective research was hold in218cases with endometrial hyperplasia diseases and EC. 3. A research was hold in47cases of endometrial atypical hyperplasia and EC diagnosed by pathology. After detecting the tissue level of VEGF、MVD、LVD, we evaluate and analyze their expression in pathological tissue to find their relativity with TCM syndromes; explore the correlation between the expression value of MVD、LVD and clinical stages、histological grade、myometrial invasion conditionResults:1. With the rapid progression of "TCM collateral disease" theory, the theory has great contribution in cardio-cerebrovascular disease. Also in tumor prevention and cure, the theory focused in Inhibitory effects on tumor angiogenesis, endothelial cell-targeted therapy and prevention on the happening of the drug resistance. Based on the TCM collateral disease theory, combined with the female physiological characteristics and EC pathophysiological specialisity, we conclude the pathogenesis of EC as "Deficiency and stagnation in uterine collaterals"、"Uterine collaterals injured by toxins"、"The masses obstruction of collaterals"2. The TCM syndromes of218cases varied in4syndromes:"qi deficiency""blood-heat"、"blood stasis"、"accumulation of damp toxins". With developing progress of endometrial hyperplasia diseases from hyperplasia to carcinoma, the proportion of "qi deficiency" decreased, the proportion of "blood-heat" and "blood stasis" increased;"accumulation of damp toxins" finally emerges in EC Defiency syndromes are the major syndromes in Endometrial benign lesion, and most of them are "kidney deficiency" and "spleen deficiency"."Blood-heat" and "blood stasis" are the major sydromes both in endometrial atypical hyperplasia and EC, as well as the difiency sydromes were less common3. The expression value and positive proportion of VEGF、MVD and LVD in EC are higher than those in endometrial atypical hyperplasia, with statistical significance.4. In the47cases of endometrial atypical hyperplasia and EC, the highest value of VEGF、MVD and LVD can be seen in "accumulation of damp toxins" syndrome."Blood-heat" has the lowest VEGF level, followed by "qi deficiency" and "blood stasis". The expression level of MVD and LVD lines the lowest in "qi deficiency", and highest in "accumulation of damp toxins". The level of MVD is much higher in "Blood-heat" than "blood stasis"; but LVD is on the contrary. Correlations also can be found between the value of MVD、LVD and clinical stages、histological grade、myometrial invasion condition.Conclusion:1. Based on the TCM collateral disease theory, combined with the female physiological characteristics and EC pathophysiological specialicity, we conclude the pathogenesis of EC as "Deficiency and stagnation in uterine collaterals"" Uterine collaterals injured by toxins" and " The masses obstruction of collaterals"."Deficiency and stagnation in uterine collaterals" is the initial factor;"Uterine collaterals injured by toxins" is the fundamental cause; and "The masses obstruction of collaterals" is the key link.2."Qi deficiency"、"Blood-heat"、"Blood stasis"、"Accumulation of damp toxins" are the four TCM syndromes in endometrial hyperplasia and EC."Qi deficiency" are the major syndromes in endometrial benign lesions, and most of them are "kidney deficiency", followed by "spleen deficiency". In non-endometrial benign lesions,"Blood-heat" and "Blood stasis" are the major syndromes instead of "Qi deficiency". The results indicate that "Invigorating qi and strengthening body resistance" could be a key method in endometrial benign lesions therapy."Detoxification"、"Clots Absorption"、"Dredging collaterals" combined with "Invigorating qi and strengthening body resistance" method could have much better curative effects in endometrial atypical hyperplasia and EC therapy. The therapy methods choose from "Detoxification and dredging collaterals" or "Clots absorption and dredging collaterals", are mostly depend on the proportion of "Blood-heat"、and "Blood stasis" in the very syndrome.3. The expression level of VEGF、MVD and LVD are much higher in EC than in endometrial atypical hyperplasia. In the47cases of endometrial atypical hyperplasia and EC, the highest value of VEGF、MVD and LVD can be seen in "accumulation of damp toxins" syndrome; followed in order by "blood stasis""qi deficiency","blood-heat" on VEGF; followed in order by "blood stasis""blood-heat","qi deficiency" on MVD; and followed in order by "blood stasis","blood-heat","qi deficiency" on LVD."Dredging collaterals" could be an effective method in clinical therapy according to TCM syndrome differentiation. Combined analysis of MVD and LVD could precisely evaluate growth、metastasis and prognosis of EC.