Immune Mechanism Of Correlation Between TCM Syndromes And Prognosis Of Advanced Colorectal Cancer

The incidence of colorectal cancer rise significantly in China in recent years,and one is already the most commonmalignant tumorto effect the health of chinese people.The colorectal tumor is ranked fourth in all tumor diseases,which is a serious threat to human survival and health.Especially with some treatments,such as radiotherapy and chemotherapyin advanced patients,the curative effect also did not live up to expectations.Therefore, the patient’s quality andsurvivalproblem in the advanced tumor remains a huge challenge.A large number of studies have shown that traditional Chinese medicine (TCM) can improve the patients life quality and we also observed the survivalof theadvanced colorectal cancer patients with different TCM characteristics is also different and the difference existsprobably some regularity.To clear the phenomenon, we retrospectively analyzed the correlation of different characteristics and prognosis of TCM, and explore its possible mechanism theory in the immunology.This article is divided into three parts,includes review, retrospective case control study and cross-sectional study.The first part discusses that the relationship between TCM syndrome type and immune index; The second part talksabout that whetherthe TCM characteristic factors correlated to the prognosis in advanced patients;The last part concentrates on previous research conclusion which discussesthe relationship betweencharacteristics of TCM and the prognosiswith the immunological factorstoclarify their internal relation and the immune mechanism.The following two parts:a brief introduction of the clinical research:Clinical Study I:correlation betweenTCM syndrome types and prognosis inadvancedcolorectal cancerObject:Based on the clinical retrospective investigationof patients in advanced colorectal cancer,analyzing the statistical of survey data is to investigate the characteristics of TCM in advanced patients with factors and prognosis of relevance. Methods:We chose the patientsin advanced colorectal cancer fromXiyuan hospital’s oncology from January 2001 to April 2015, and founded a database of somebasic information about patients, including 19 patients at or less than 17 months’ survival period who fall under the observation group, at the same timewefound76 cases ofthe different survival period of patients into control group who beyond 18 months.Then we tookage, sex, parts asthe match factorsto found the database by 1:4 matching selection through a retrospective nested case-control study.Therefore,werespectively analyzed its correlation with the prognosis of survival from two aspects of TCM treatment time and TCM syndrome types.Results:Theagesbetween eachgroup of the 95advanced patients have significant difference (P<0.05), and sex and tumor site have no significant statistical difference. The liver depression and spleendeficiency syndrome is the majority TCM syndrome typesin the the observa -tion group,whilein the control group the majority TCM syndrome typeis the spleen and kidney deficiency type. In the observation group and control group patients usingTCMfor less than 6 monthsis statistically significant different from the one taking 12 months (P<0.01). With statistical analysis, the liver depression and spleendeficiency syndrome is the important factor that influence the survival prognosis statistically significant (P=0.007<0.01).Conclusions:Long-term treatment of TCM may play animportant role in the ext ension of advanced colorectal cancer survival time. TCM syndrome type and s urvival outcome has certain relevance, andthe liver depression and spleendeficienc y syndrome with a poor prognosis iscompared to most other kind of this syndr ome.Clinical Study Ⅱ:Associationbetween each syndrome type and the immune mechanism at different stagesin advanced colorectal cancerObject:We detected immune cells, cytokines and other indicators ofpatients inadvanced colorectal cancer, andanalyzed the relationshipbetweenimmune indexesand TCM syndrome typeat different stagesto try to clarify thecharacteristics of traditional Chinese medicine’s relationship with prognosisfrom the perspective of immunology.Methods:Theproportion of the incidence of 72 advanced patients in male and female is about 1.63:1.The ageaccords withnormally distributed, andin which51 to 70 years is the high incidence of the age (P<0.01).Through quantitative research, compared with the normal range,the liver depress-ion and spleendeficiency syndrome showsthe higher expression levels of the Th2, Treg cells, and the lower expression levels of Th17, Ts cells(P<0.05);Liver an d kidney deficiency type showsthe lower expression levels of Th1,Th17 cells(P <0.05).The difference of the immune cells level compared between different sy ndrome types in different phaseshas not reached statistical significance (P>0.05). Thelevels of VEGF-A,IL-6,IL-10,inthe liver depression and spleendeficiency synd rome type have reachedstatistical significance comparing with the normalrange (P<0.05);Thelevels of TNF-α and INF-gammainLung and kidney deficiency type have reachedstatistical significance comparing with normal range(P<0.05). Thedifference of cytokines level comparing between different syndrome types in different phaseshas not reached statistical significance (P>0.05).Conclusions:T lymphocyte subsets changes in the peripheral blood ofpatients in advanced colorectal cancer showed that the immune function is suppressed, and the data is reliable.The liver depress -ion and spleendeficiency syndrome type with immune function suppression is more obvious than other kind of the syndrome type, which showed that patients in advanced colorectal cancer with the liver depression an-d spleendeficiency syndrome type, the disease may change in progress;Whenwith lung and kidney deficiency syndrome type, the disease may be in a relatively stable state.In cytokines ofadvanced patients,the high level of bFGF, MDC may be a factor of tumor progression, Flt-3L and IL-2Ra may play a role in the inhibiting tumor progress.Thereforethe balance between two groups of cytokines keep the body’s statestable.The high level of MMP3 in liver and spleen discord syndrome type and the high level of bFGF inliver and kidney deficiency type may be both the intrinsic factors of disease progressionin advanced patients.Unfortunately, the study based on the research project can not wait for the open results which would be put with the survival time in comparative analysis because of shorter time.And the fewer sample size may result in no significant trend, which willbe in further expandedto dig the regulation,andthe association between survival analysis of the advanced patients and the extension of TCM intervention time.