Effect Of Spleen-based Chinese Medicine Treatment On Survival Of Advanced Gastric Cancer And Experimental Study

Objective:To observe what impacts the compound preparation that was developed based on the spleen-invigorating Traditional Chinese Medicine（TCM）had on the patients with advanced gastric cancer.In the meantime,study what roles acacetin plays during the proliferation and apoptosis of MGC803,a gastric cancer cell.Acacetin is extracted from Pseudostellaria Heterophylla of WCA,a compound spleen-invigorating TCM.Method:The target of this study are those registered cases with advanced gastric cancer who meet filtering criteria.Non-randomized concurrent control study has been made.The cases are halved–one team receives TCM combined with chemotherapy treatment,the other as a control group simply gets chemotherapy,with Overall Survival（OS）as the end of the study around each individual.Cox multiple regression analysis has been made to analyze their survival conditions,and the Kaplan-Meier approach has been used to calculate the median survival time of each team.CCK-8 has been carried out to examine how well acacetin inhibits the proliferation of the gastric cancer cell MGC803;the technique flow cytometry has been applied to inspect cells’apoptosis;apoptotic morphology of those cells undergoing Hoechst staining has been observed;protein immunoblot experiment has been carried out to verify how acacetin leads to the cancer cells’apoptosis.Result:A total of 624 cases with advanced gastric cancer had been enrolled to study.267 cases belong to the TCM therapy group while 357 cases the control group.With multivariate analysis applied,it showed that:The TCM treatment（P=0.004）and the palliative chemotherapy（P=0.007）are the independent prognostic factors that impact the survival time of those suffering this sort of cancer.The median survival time of the TCM group is 18.05 months,while that of the control group is 12.49 months.Between the two data exists statistical difference（P=0.001）.The survival rate of those,who receive TCM therapy and survive 1,2 and 3 years,is respectively 69.10%,36.10%and 22.30%;that of the patients in the control group who survive 1,2 and 3 years is respectively 50.60%,26.40%and 20.50%.With the Propensity Score Matching being applied,490 qualified cases had been selected in pairs for further study.Among them,245 cases come from the TCM therapy group,and another half from the control group.Afterwards,multivariate analysis has been adopted,and the following has been found:The TCM therapy（P=0.027）remains an independent prognostic factor that influences the survival period of those with advanced gastric cancer.The median survival time of the TCM group is 18.15 months,while that of the control group 13.79 months.These two data present statistical difference（P=0.042）.The survival rate of those,who belong to the TCM group and survive 1,2 and 3 years,is respectively 68.90%,35.10%and 21.70%.That of those,who were selected from the control group and have managed to live 1,2and 3 years,is respectively 55.40%,28.80%and 22.90%.The CCK-8 approach has been used to examine how well acacetin–an effective component of a spleen-invigorating TCM called Pseudostellaria Heterophylla–works to inhibit the proliferation of the cancer cell MGC803.Based on calculation,the value of IC₅₀ in 48 hours is 30μmol/L.In accordance with this,cases are sliced into 3–a blank control,a high-dose group,and a low-dose group.Through the use of flow cytometry and Hoechst staining,it has been found that the apoptosis of the high-dose group is much more evident than that of the blank control,and the apoptotic bodies of the former is obviously more than that of the latter.With the protein immunoblot measure being applied to examine Caspase 3 and Bcl-xl proteins,the high-dose group and the blank control have been compared,and this experiment has shown that,as the Caspase3 expressions of both groups have experienced up-regulation,their Bcl-xl expressions have undergone down-regulation.No evident difference has been discovered when the low-dose group and blank control were compared.Conclusion:The TCM,whose primary function is to invigorate spleen,can be taken as an independent prognostic element of those cases with advanced gastric cancer,and they can lengthen the overall survival of pertinent cases.As an effective component of Pseudostellaria Heterophylla–a spleen-invigorating TCM–acacetin is able to inhibit the proliferation of the cancer cell MGC803 and facilitate their apoptosis.