| Objective:To study syndrome elements distribution characteristics, neurotoxicity grading and their relationships to GSTP1 genetic polymorphism in the colorectal cancer patients undergoing the oxaliplatin-based chemotherapyn. To understand the pathogenic mechanism of the side effect of chemotherapy in order to improve the prevention and treatment for the chemotherapy adverse reaction in a way combined with Chinese traditional and western medicine. To play the unique advantages of traditional Chinese medicine to reduce toxicity, Also for the further study of chemotherapy pathological changes of congenital genetic factors lay the foundation of traditional Chinese medicine.Methods:The diagnostic data of 100 cases of colorectal cancer were collected in a standardized way and the collected data are applied for the method of the syndrome elements differentiation and analysis for the distribution of location and nature syndrome elements of pattern. At the same time,2ml venous blood of patients with colorectal cancer was collected and restriction fragment length polymorphism polymerase chain reaction technology (PCR-RFLP) was used to detect the GSTP1 genetic polymorphism using the blood sample of each patients.Results:1.A totle of 100 cases of colorectal cancer patients undergoing oxaliplatin-based chemotherapy were included in this study. All the patients were divided into three groups,16 cases of non chemotherapy group,49 cases of the early chemotherapy stage group (1-3 cycles),35 cases of the middle chemotherapy stage group (4-6 cycles). The study population was consisting of:54 male patients and 46 female patients, ranging in age from 18 to 75 years old; 46 cases of colon cancer and 54 cases of rectal cancer; pathological staging:41 stage Ⅱ patients and 59 stage III patients.2.Colorectal cancer patients’location syndrome elements of pattern spleen in the Mid chemotherapy group is significantly different form the other two groups (P<0.05). the frequencies of syndrome elements of liver, large intestine, lung and stomach showed a upward trend. But the kidney syndrome elements has a downward trend. The nature syndrome elements of pattern qi stagnation and qi deficiency in Mid chemotherapy group had significant difference (P<0.05) compared with the other two groups. There were syndrome elements, dampness, phlegm, blood deficiency and yin deficiency showed raising trend.3.Early chemotherapy stage group and mid chemotherapy stage group compared with no difference (P>0.05) in the frequency of grade 0 neurotoxicity. The frequency of grade Ⅰ, Ⅱ, Ⅲ neurotoxicity in the mid chemotherapy stage group had significant difference (P<0.05) compared with early stage group.4.In early chemotherapy stage group, mid chemotherapy stage group, the neurotoxicity frequency is not related to AA genotype carriers and AG+GG genotype carriers (P>0.05). In the non-chemotherapy group, the frequency of location syndrome elements of pattern kidney in the AA genotype carriers had significant difference (P<0.05) compared with AG+GG genotypes carriers. In both early chemotherapy stage group and mid chemotherapy stage group, the difference of syndrome elements frequency distribution between different GSTP1 genetic genotype carriers had no statistical significance (P>0.05).Conclusions:1.Colorectal cancer patients in the different stages of chemotherapy syndrome elements distribution characteristics:oxaliplatin mainly affected the syndrome elements may be spleen, followed by liver, large intestine, lung, stomach and kidney. The most common disease syndrome elements may be qi deficiency and qi stagnation, which followed by wet, phlegm, blood deficiency and yin deficiency, traditional Chinese medicine pathological mechanism of toxic effects in the course of chemotherapy for patients with rectal cancer.2.In the non-chemotherapy group, syndrome elements renal had a trend that its frequency in the AA genotype carriers is higher than that in AG+GG genotypes carriers. GSTP1 may be affect the syndrome elements of renal genes before chemotherapy, In our study, the GSTP1 genetic genotype was associated with neither neurotoxicity nor the frequency distribution of location syndrome elements of pattern in the early chemotherapy stage group and mid chemotherapy stage group of colorectal cancer patients, the GSTP1 genetic genotype wasn’t associated with the frequency distribution of nature syndrome elements of pattern in the non-chemotherapy group, early chemotherapy stage group and mid chemotherapy stage group of colorectal cancer patients. This result suggested that the genetic polymorphism of GSTP1 should be not the main factor affecting the occurrence of neurotoxicity and syndrome elements.3.Neurotoxicity grading was increasing and serious with does of chemotherapy generally. |
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