The Study Of The Relationship Between Syndrome Type Of Chinese Medicine And Related Clinical Factors Of Cervical Cancer

ObjectiveCarrying out a preliminary study of the relationship between syndrome type of Chinese medicine and Related clinical factors of Cervical cancer, mainly discussing the relationship among different pattern of syndrome, clinical staging of the tumor and postoperative metastasis and so on.MethodsCollecting100cases of hospitalized patients with cervical cancer in Guangdong hospital of TCM and zhong shan hospital in January2013-March2014, which has been diagnosed pathologically, gathering patients symptoms on the day when they was hospitalized, filling in the syndrome differentiation type table, judging Syndrome differentiation type on the basis of syndrome differentiation standard.recording clinical stage and checking the squamous cell carcinoma antigen before operation. According to the operation records and postoperative pathologic results, judging metastasis and infiltration of cervical cancer and so on. Conducting Statistical analysis to observe the type of syndrome of cervical cancer, observing the relationship of dialectical classification and pathological type and clinical stage and tumor metastasis.Results1. Included in the100cases of patients with cervical cancer which are meeting the standard, the oldest one is65and youngest,26, mean age48.56±9.10years old. the onset age mainly concentrated after the age of40(80%), while of which over the age of50in cervical cancer come in more frequently (46%).2. Cervical cancer patients accept a lower education commonly, High school or above education level accounted for only25%. Maternal side, the survey of cervical cancer patients has a history of multiple pregnancy and production (all3times or higher), of the total frequency is higher, which is141frequency. Seeing a doctor Because of abnormal vaginal bleeding patients accounted for79%.3. Observing by the naked eye, exogenous type had53cases (53%), endogenous type8cases (8%), ulcerative11cases (11%), the cervical canal type1case (1%), cervical erosion type15cases (15%), no obvious abnormal12(12%). Thus, we can say the most common type in100patients with cervical cancer are exogenous ones, while the least ones are the cervical canal ones.4. In the study of100patients,59patients tested the HPV types, the results showed that the proportion of HPV16+, HPV45+was higher, followed by HPV18+, which explains the main type of HPV infection with cervical cancer is HPV16,45and18.5. SCC expression in tumor markers:3cases of unchecked (3%),64cases of negative (64%),33cases (33%) were positive. And CA125:87cases of negative (87%),13cases (13%) were positive, CA199:90cases of negative (90%),10cases (10%) were positive, CEA:90cases of negative (90%),10cases (10%) were positive, CA153:96cases of negative (96%),4cases were positive (4%). It is visible for cervical cancer that SCC is relatively sensitive tumor markers, while the positive rate of CA199, CA153, CA125, CEA and AFP marker were low.6. in the100cases of cervical cancer patients, the result of clinical stage was that stage ⅠA1had17cases (17%), stage ⅠA21case (1%), stage ⅠB129cases (29%), stage IB218cases (18%), stage ⅡA1there are19cases (19%), stage ⅡA27cases (7%), stage ⅡB9cases (9%). In conclusion, ⅠB1for this study, is the most common period, followed by stage ⅠA1, ⅠB2, ⅡA1.7. In the mode of operation for100patients with cervical cancer,9cases of which accepted panhysterectomy (9%), while74cases Radical hysterectomy (74%),17cases accepted other operation (17%), including2cases of laparoscopic total hysterectomy (2%),7cases accepted radical hysterectomy with paraaortic node resection (7%),3cases accepted subradical hysterectomy (3%), etc.8. AS to the transfer of disease,29cases with lymphatic metastasis,(29%), lymph node metastasis, including2cases of abdominal aorta lymph node metastasis, simply spread directly without lymph node metastasis in66patients (67%),4cases were carcinoma in situ (4%), and no case in hematogenous metastasis. Visible in this investigation100cases of transfer mode is given priority to with direct spread, followed by lymph node metastasis, and hematogenous metastasis-often appear in advanced disease, which did not see in the survey.9. AS to the degree of differentiation,15cases (15%), are high differentiation, while Moderate differentiation50cases (50%), low differentiation20cases (20%), between low and moderate differentiation5cases (5%), between high and moderate differentiation7cases (7%), the differentiation of3patients are unknown (3%). Thus, we can make a conclsion that in the survey, most common type of the differentiation in patients with cervical cancer tissue is moderate differentiation, high differentiation account for only15%of them.10. AS to the Pathological types,78cases are cervical squamous cells infiltrating carcinoma (78%), while1case adenosquamous carcinoma (1%),15cases adenocarcinoma (15%),4cases were carcinoma in situ (4%), and other types have2cases (2%), including1case of small cell lung carcinoma of the cervical,1case of small cell lung carcinoma of the cervical and with high differentiated squamous carcinoma. Thus, in the survey of the pathological type of cervical cancer, the most common type is cervical squamous cells infiltrating carcinoma, adenocarcinoma second, adenosquamous carcinoma and other types are rare.11. Summarizing the symptoms of patients with cervical cancer, we find that the highest frequency of15symptoms are:abnormal vaginal bleeding (76), fatigue and weakness(64), poor sleep(61), dry mouth (55), loss of appetite (50), an ache in his waist and back (42), depression(37), abnormal leucorrhea (36), bitter taste (34), be agitated to anger (29). These symptoms are also symptoms of top scoring at the same time, which the most serious symptoms.12. Reviewing cases observed in the table of TCM symptoms and tongue pulse information:23cases are stagnation of liver qi types in the type of syndrome (23%),9cases, blood stasis resistance types (9%),5cases, humid heat with blood stasis resistance types (5%),9cases are phlegm-damp types (9%),26cases are Yang deficiency of spleen and kidney types (26%), and28cases are Yin deficiency of liver and kidney types (28%). Thus, the most of three types are stagnation of liver qi, Yang deficiency of spleen and kidney and Yin deficiency of liver and kidney. these three types were similar in number, what a little more to see are Yin deficiency of liver and kidney types. 13. Analyzing the relationship between Cases of SCC positive expression and age, the degree of differentiation, metastasis ways, clinical stage and so on, we found that the degree of differentiation, lymphatic metastasis, clinical stage, pathological type, production times, and education have statistically significance (P<0.05), and the production time, clinical stages, lymphatic metastasis are significant difference (P<0.01).14. Analyzing the relationship between the proportion of synptom type and clinical related factors, we find that different age groups, work load and maternal times, type of naked eye, positive HPV, most tumor markers (including SCC, CA125, CA153, CA199, CEA and AFP), clinical stage, preoperative chemoradiotherapy, pathological type, degree of differentiation have no statistical differences (P>0.05). while positive expression of CA724, education degree, the chief complaint have statistically significance (P<0.05).15. Logistic regression analysis between Related factors and TCM syndrome type of cervical cancer(1) CA199and degree of differentiation may be the protective factor of Yang deficiency of spleen and kidney types (negative correlation), Respective relative risk (OR)=0.040,0.394, and respective P=0.035,0.029, respective confidence interval=0.002to0.799,0.171to0.907, which are statistically significant (P<0.05). CEA may be the risk factor of Yang deficiency of spleen and kidney types (positive correlation), relative risk (OR)=2.447, P=0.006, confidence interval=2.447to208.591, which is statistically significant (P<0.05).(2) Complaint may be the propective factor of Yang deficiency of spleen and kidney types (negative correlation), and CA199may be the risk factor(positive correlation). respective relative risk(OR)=0.403,16.659, and respective P=0.020、0.011, confidence intervals.187to0.868、1.909to145.369, which are statistically significant (P<0.05). CEA may be the propective factor of Yang deficiency of spleen and kidney types (negative correlation), respective relative risk(OR)=0.094, but respective P>0.05, which isn’t statistically significant.(3) By Logistic regression analysis, there is no factor come into the regression equation of stagnation of liver qi types.Conclusion: 1. In this study of100patients with cervical cancer, the most common TCM syndrome type is Yin deficiency of liver and kidney, which accounts for28%of all TCM syndrome types. The second one is Yang deficiency of spleen and kidney, which accounts for26%. The third one is stagnation of liver qi, which accounts for23%, all these three types account for77%. Liver symptoms such as dry mouth and bitter taste, depression, abnormal leucorrhea and be agitated to anger also occurs frequently, spleen symptoms such as fatigue and weakness, loss of appetite and dizziness and tinnitus are common symptoms, as well as kidney symptoms such as an ache in his waist and back, cold waist and knee, forgetfulness, nocturia, etc. In consequence, the occurrence of the cervical cancer is closely related to the liver and spleen and kidney.2. In the very early stage, the cervix seems normal, and the TCM syndrome type are always stagnation of liver qi and stagnation of blood stasis, with the disease developing, Yin deficiency of liver and kidney is more and more common to see. Thus, we can speculate that live may affect the onset and process of cervical cancer from beginning to end.3. The study showed a certain degree of correlation among the TCM syndrome types and SCC positive and the clinical factors of cervical cancer, which have a guidance function to prevent and treat cervical cancer with traditional Chinese medicine.