A Study On Relationship Between TCM Syndrome Differentiation And RAS And BRAF Genes In Left And Right Colon Cancer

Objective:To observe the differences and regularities in the distribution of TCM syndrome types of left and right colon cancers,and to provide more precise TCM differentiation and treatment directions for patients with left and right colon cancer;to explore the relationship between RAS and BRAF genes in TCM syndrome type of colorectal cancer,To provide an objective basis for TCM syndrome differentiation and treatment of TCM and western medicine for colorectal cancer;to pay attention to whether there is a certain difference in the distribution of TCM syndrome types of left and right colon cancers in the same gene state,which is left and right colon cancer.Provides new directions for thinking about differences in treatment efficacy.Method:A total of 176 patients with colorectal cancer who met the standard of hospitalization in Fujian Provincial Hospital(oncology,surgical oncology,and gastrointestinal surgery)from February 2017 to February 2018 were selected and divided into colonic splenic flexures as the dividing line.The left colon cancer and the right colon cancer were collected from the four preoperative medical examinations.The two deputy chief physicians instructed TCM syndrome differentiation.At the same time,the clinical data of postoperative patients with colorectal cancer were retrospectively collected,including gender,age,clinical initial symptoms,gross tumor type,histopathological type,clinical TNM stage,MMR gene expression,RAS(KRAS and NRAS)and BRAF gene mutations.Situation and other indicators.SPSS20.0 statistical software package was used to establish a database to observe the clinical data of left and right colon cancers and the differences and regularity of the distribution of syndromes of traditional Chinese medicine.At the same time,the relationship between TCM syndrome type and RAS and BRAF genes in colorectal cancer was also discussed.And concerned about whether the left and right colon cancers have certain differences in the distribution of TCM syndrome types under the same genetic conditions.Measured data were tested by rank sum test.Count data were analyzed by chi-square test and P<0.05 was considered statistically significant.Results:1.A total of 176 patients with colorectal cancer were included:104 cases(59.1%)of left colon cancer,with an average age of(63±14)years;72 cases of right colon cancer(40.9%),mean age(61 ±20)year old.After the X2 test,there was no significant difference in the distribution of gender,age,gross tumor type,histopathological type,invasion of vasculature,and clinical TNM staging in patients with left and right colon cancer(P>0.05);The differences in the distribution of symptoms,RAS,BRAF gene mutation,and MMR gene expression were statistically significant(P<0.05).2.In 176 cases of colorectal cancer,52 cases(29.5%)were qi stagnation and blood stasis type,32 cases(18.2%)were hygrothermal atrophy type,39 cases(22.2%)were qi and blood deficiency type,and 41 cases were spleen and kidney yang deficiency type(23.3).%),liver and kidney yin deficiency type in 12 cases(6.8%).Among them,the proportion of qi stagnation and blood stasis is the highest,and the proportion of liver and kidney yin deficiency is the lowest.After examination,there was no significant difference in the distribution of gender,age,gross tumor type,histopathological type,and clinical TNM stage(P>0.05).3.Among 104 cases of left colon cancer,36 cases(34.6%)were qi stagnation and blood stasis,29 cases(27.9%)were damp and heat conjunctive,10 cases(9.6%)were qi and blood deficiency,and 21 cases were spleen and kidney yang deficiency.(20.2%),liver and kidney yin deficiency type in 8 cases(7.7%).Among the 72 cases of right colon cancer,16 cases(22.2%)were qi stagnation and blood stasis,3 cases(4.2%)were hydrothermal adenomyosis,29 cases(40.3%)were qi and blood deficiency,and 20 cases were spleen and kidney yang deficiency.(27.8%),4 cases of liver and kidney yin deficiency(5.5%).After the X2 test,the distribution of left and right colon cancers in TCM syndromes was different,with statistical significance(P<0.05).The left half of colon cancer was mostly qi stagnation,blood stasis type,and damp heat accumulation syndrome type.The right half colon cancer was mostly qi and blood deficiency type and spleen and kidney yang deficiency type,which had statistical significance(P<0.05).4.There were differences in the frequency of RAS mutations,BRAF mutations,and wild-type distributions in TCM syndromes of colorectal cancers,with statistical significance(P<0.05):The frequency of gene expression in patients with qi stagnation and blood stasis type was significantly higher than that of qi and blood deficiency type.The frequency of gene expression of RAS mutation or BRAF mutation was significantly higher in qi stagnation and blood stasis type patients than in qi stagnation and blood stasis type.The difference was statistically significant.(P<0.005);There was no statistically significant difference between TCM syndromes(P>0.005).5.There were 89 cases of RAS mutations in colorectal cancer,of which the qi and blood deficiency type accounted for the highest proportion(P>0.05);8 cases of BRAF mutations,of which qi and blood deficiency type accounted for the highest proportion(P>0.05);wild type 79 In the example,the proportion of qi stagnation and blood stasis was highest(P<0.05).6.Among the 89 cases with RAS-mutant colorectal cancer,most of the left-sided colon cancers were hot and humid atrophy type,and the right-sided colon cancer was mostly patients with deficiency of blood and blood,and the difference was statistically significant(P<0.05);Among the 8 patients with BRAF-mutant colorectal cancer,most patients with qi stagnation and blood stasis were left-sided colon cancer,and patients with right-sided colon cancer were mostly qi stagnation and blood deficiency(P<0.05);Among the 79 cases of wild-type colorectal cancer,there were mostly qi stagnation and blood stasis in the left colon cancer,and spleen and kidney yang deficiency in the right colon cancer.The difference was statistically significant(P<0.05).Conclusion:1.The patients with qi stagnation and blood stasis type and damp heat accumulative syndrome type were more common in the left-term colon cancer with better overall prognosis.The patients with qi and blood deficiency type and spleen-kidney yang deficiency were the patients with poor overall prognosis.Mostly.It is suggested that patients with qi stagnation and blood stasis type and damp heat conjunctival type may have a better prognosis.Patients with deficiency of qi and blood type and spleen and kidney yang deficiency may have poor prognosis.In the treatment of clinical syndrome differentiation,left colon cancer should pay attention to qi qijie,heat and dampness,right colon cancer should strengthen qi and blood,warming spleen and kidney.2.Patients with qi stagnation and blood stasis type are more likely to have a wild-type gene than those with a deficiency of qi and blood,while patients with qi stagnation and blood deficiency may have a greater probability of RAS or BRAF mutation than qi stagnation and blood stasis.3.Among patients with wild-type colorectal cancer with good anti-EGFR monoclonal antibody targeted therapy,the proportion of patients with qi stagnation and blood stasis is highest,suggesting that patients with qi stagnation and blood stasis may be sensitive to anti-EGFR monoclonal antibody targeted therapy.4.1n wild-type left and right colon cancers,patients with qi stagnation and blood stasis are the majority of left colon cancer,and patients with spleen-kidney yang deficiency are the majority of patients with right colon cancer,suggesting that anti-EGFR monoclonal antibody is targeted for spleen and kidney yang deficiency.Patients may have poorer efficacy than qi stagnation and blood stasis type patients.