Study On The Relationship Between Tongue Bacteria,Cancer Toxicity And Constitution In Different Pathological Stages Of Colorectal Cancer

Objective:To study and analyze the relationship between the constitution,cancer toxicity and tongue mosses flora of patients with different pathological stages of colorectal cancer by means of questionnaire survey,and explore the correlation among them,so as to provide a strong basis for the prevention and treatment of colorectal cancer by combining traditional medicine with modern microorganism and traditional Chinese medicine and cancer toxicity pathogenesis theory.Method:1.During June 2019 to June 2021 in Jiangsu province hospital of Cancer medicine、Cancer surgery、Digestive endoscope clinic and pathological diagnosis of colorectal cancer patients were collected in hospital.According to the literature and clinical data,we formulate and fill in the patients with colorectal cancer statistics,cancer classification and pathological factors constitution questionnaire,collecting and establish the database,comparative analysis and statistical method.2.Patients with colorectal cancer,according to the pathological stage were divided into two groups before and after,the former group for the patients with pathological stage of Ⅰ-Ⅱ,after the group stage for pathological staging Ⅲ-Ⅳ patients,two groups in the extraction of 21 and 35 patients respectively,and then randomly selected 20 people,from a health check-up crowd as healthy controls,through collecting tongue coating for 16 srna high-throughput sequencing and bioinformatics analysis,conclusion of three groups of tongue coating flora composition,diversity and abundance of contrast and analysis of some important species,difference,the physique,cancer of different pathological staging and tongue coating flora for correlation analysis.Results:1.General information:Among the 312 patients collected,168（53.8%）were colon cancer patients and 144（46.2%）were rectal cancer patients.There were 199 male patients（63.8%）and 113 female patients（36.2%）,with a male-to-female ratio of 1.76:1.Of the diagnosis time,73 cases（23.40%）visited the hospital within 14 days or less.Among the first symptoms,115 cases（36.9%）had blood in stool,71 cases（22.8%）had changed stool habits,78 cases（25.0%）had abdominal distension and abdominal pain,4 cases（1.3%）had decreased appetite,and 2 cases（0.6%）had abdominal mass.One case was emaciated（0.3%）,29 cases were examined（9.3%）,and the other 12 cases（3.8%）.In the TNM stage,44 cases（14.1%）were at Ⅰ stage,105 cases（33.7%）were at Nm stage,101 cases（32.4%）were at Nm stage,62 cases（19.9%）were at N stage,93 cases（29.8%）were at uplift stage,188 cases（60.3%）were at ulceration stage,and 31 cases（9.9%）were at infiltration stage.There were 281 cases of adenocarcinoma（common type）and 31 cases（9.9%）of adenocarcinoma special type.In the degree of differentiation,37 cases（11.9%）were poorly differentiated,222 cases（71.2%）were moderately differentiated,10 cases（3.2%）were highly differentiated,39 cases（12.5%）were moderately poorly differentiated,and 4 cases（1.3%）were moderately highly differentiated.Among the primary sites,93 cases（29.8%）were left colon,89 cases（28.5%）were right colon,and 126 cases（40.4%）were rectum,either 4 complex types.Among the patients with Ⅳ stage metastases,104 cases（33.3%）had abdominal lymph node metastasis,9 cases（2.9%）had abdominal lymph node metastasis,17 cases（5.4%）had lung metastasis,52 cases（16.7%）had liver metastasis,0 cases had brain metastasis,and 2 cases（0.6%）had bone metastasis.2.Different pathological stages of traditional Chinese medicine physique distribution:Phlegm wet mass associated with colorectal cancer Ⅰ-Ⅱ period;Qi deficiency,blood stasis,Yin deficiency and colorectal cancer Ⅲ-Ⅳ period.3.Correlation between TCM（Traditional Chinese Medicine）constitutions and pathological factors of colorectal cancer:There is a correlation between humidity,heat and mass and the primary site of colorectal cancer,and the distribution type of TCM constitutions has nothing to do with the differentiation degree of colorectal cancer,gross classification and histological type.4.Distribution of cancer toxicity types in different pathological stages:heat toxicity,dampness toxicity and phlegm toxicity were correlated with colorectal cancer.5.Correlation between TCM constitution and cancer toxicity:Qi deficiency and phlegm dampness are related to phlegm toxicity,phlegm dampness and dampness-heat are related to phlegm toxicity,qi-deficiency,yin-deficiency,yang-deficiency,dampness-heat,blood stasis and qi-stagnation can all be related to stasis toxicity,yin-deficiency,dampness-heat and qi-stagnation are related to heat toxicity.6.Pathological stages of colorectal cancer and fungal flora on the tongue:at the phylum level,Bacteroidetes,Proteobacteria,Firmicutes,Actinobacteria,and Fusobacteria ranked the top five in abundance among the early and middle stage patients.In the middle and late stage patients,Bacteroidetes,Proteobacteria,Firmicutes,Fusobacteria and Actinobacteria ranked the top five in abundance.In the healthy control group,Proteobacteria,Bacteroidetes,Firmicutes,Fusobacteria,and Actinobacteria ranked the top five.At the generic level:Prevotella₇,Neisseria,Actinomyces,Streptococcus and Haemophilus were the top five in the abundance of early and middle stage patients,respectively.The abundance of Neisseria,Prevotella₇,Haemophilus,Streptococcus and Actinomyces ranked the top five in the middle and late stage patients,respectively.In the healthy control group,the top five abundance were Neisseria,Prevotella₇,Haemophilus,Streptococcus and Fusobacterium.Conclusion:1.There is correlation between pathological stage of colorectal cancer and constitution of TCM,between pathological stage of colorectal cancer and cancer toxicity,between constitution of TCM of colorectal cancer and cancer toxicity,and between pathological stage of colorectal cancer and fungal flora on the tongue.2.Blood stasis and phlegm and dampness are the susceptible constitution of colorectal cancer.Lesions in the left half of the colon are easily related to phlegm and dampness,lesions in the right half of the colon are easily related to Yin deficiency,and lesions in the rectum are easily related to dampness and heat and phlegm and dampness:3.In patients with colorectal cancer patients with different pathological stages constitution types differ,Phlegm wet mass is more valuable in diagnosing colorectal cancer at Ⅰ-Ⅱperiod,qi-deficiency and yin-deficiency are more valuable in diagnosing colorectal cancer atⅢ-Ⅳ period.4.The stasis poison throughout the course of the development process of tumor wet poison,toxic heat associated with the development of colorectal cancer Ⅰ-Ⅱ colorectal cancer.5.The constitution of TCM is correlated with the type of cancer toxicity,and the substance of Yang deficiency,phlegm dampness and blood stasis are related to cold toxicity.Qi deficiency,phlegm dampness and blood stasis are related to phlegm toxicity.Phlegm and dampness,dampness and heat are related to dampness and toxin,Qi deficiency,Yang deficiency,blood stasis,Qi stagnation and toxin,Yin deficiency,dampness and heat are related to heat toxicity.6.There are differences in tongue coating flora between colorectal cancer patients and healthy people,mainly manifested in the abundance of Gram-negative bacilli detected.Patients with Qi-deficiency and Yin-deficiency of colorectal cancer are more likely to be infected with Gram-negative bacilli.7.In the early stage of colorectal cancer,the lingual licsing flora is already disregulated.With the progress of colorectal cancer,the lingual licsing flora of colorectal cancer becomes more disregulated,mainly reflected in the decrease of beneficial flora and the increase of harmful flora.