Study On The Difference Between TCM Constitution Factors And The Expression Of Chromosome Karyotype And Gene Mutation In Patients With Myelodysplastic Syndrome

Objective:To explore the differences in karyotype,gene mutation and prognosis of MDS patients with different constitutions.Methods:Chromosome karyotype analysis was performed on 313 patients with MDS and the mutation status of bone marrow mononuclear cells in 194 patients was detected.According to the IPSS-R system,the patients were graded prognostically,and the karyotype was divided into three levels:"good","medium" and "poor"."Includes" poor"and" very poor "of the IPSS-R system.According to the TCM constitution classification and judgment self-test table(China Traditional Chinese Medicine Society Standard),all patients will be classified for constitution.The statistical method was used to analyze the correlation and difference of TCM constitutional factors with karyotype and common mutations of MDS,and the difference in prognosis.Results:1.Among all the 313 patients with chromosome analysis,the constitution of MDS patients was dominated by biased constitution,and qi-deficiency,yin-deficiency,yang-deficiency,blood stasis and damp-heat were common.There was a significant difference in the proportion of blood stasis between the relatively low-risk group and the relatively high-risk group(P<0.05),and no significant difference in the rest of the body constitution(P>0.05).2.MDS patients with chromosomal abnormalities accounted for 51.76%(162/313),the most common abnormal chromosome is+8,a total of 36 cases.3.The distribution of TCM constitutions in chromosome karyotype is uneven,and the proportion of biased constitution is large.The most common group of chromosome karyotype "good" is Qi deficiency,the most common group is "yin deficiency","poor" The most common is blood stasis.4.The distribution of chromosome karyotypes in MDS patients with different constitutions was significantly different(P<0.05).Blood stasis was more common in the group with "poor" karyotype.5.Among all the 313 patients who underwent chromosome analysis,95 died during the follow-up period.No median survival time was found in the "good" karyotype group during the follow-up period.The median survival time was 19 months in the middle and 14 months in the poor karyotype group,and the difference in survival time between the different karyotype groups was significant(P<0.05).The MDS patients with common qi deficiency,Yin deficiency,Yang deficiency,blood stasis,humid five physical survival analysis,deficiency of mass,damp and hot,blood stasis patients with mass median survival time were 22,19,15 months,Yang deficiency,Yin deficiency patients with mass in the follow-up period not,it is concluded that the median survival time has a significant difference between groups(P<0.05).6.In all the 194 patients who underwent gene mutation detection,there was no significant difference in the mutation rate of TET2 gene in the relative risk stratification(relatively low,high risk)(P1>,0.05).The mutation rates of ASXL1,TP53 and RUNX1 genes were significantly different(P2,P3 and P4 were all<0.05).7.The mutation rates of TET2,ASXL1,TP53 and RUNX1 genes in MDS patients with different constitutions were not significantly different(all P values were>,0.05).8.81 of the 194 patients undergoing genetic mutation testing died,and there was no significant difference in median survival time between TET2,RUNX1 mutant and wild-type patients(all P values>0.05);ASXL1,TP53 mutant and wild-type The median survival time of patients was significantly different(all P values<0.05).Conclusion:1.The most common constitution of MDS IS QI deficiency,Yin deficiency,Yang deficiency,blood stasis and damp-heat.The ratio of blood stasis in the relatively high risk group was higher than that in the relatively low risk group,and the median survival time was the shortest.2.Patients with ASXL1,TP53 and RUNX1 mutations are at high risk of progression to high-risk,and patients with ASXL1 and TP53 mutations have a shorter survival time.3.TCM constitution is related to MDS relative risk stratification(relatively low,high risk),karyotype and prognosis.TCM constitution can be used as a reference factor for MDS prognosis evaluation.Studying the constitution and genetics of traditional Chinese medicine is conducive to judging the prognosis of MDS,and taking targeted treatment measures in time.