| Purpose:In this study,we focused on the systematic review and comprehensive evaluation of micrometastases in peripheral blood of breast cancer by Small Breast Epithelial Mucin(SBEM)in January 2002 to December 2016.To investigate the relationship between the expression of SBEM in peripheral blood of patients with breast cancer and the TCM syndromes of breast cancer.Material and method:1.Using the methods of computer retrieval,the paper abstracts the full text of Pub Med,CNKI,VIP,Wan Fang Data and Springer Link from 2002 to 2016,and uses the method of combining keywords and free words.Chinese search terms include breast cancer,mammary epithelial mucin,English search terms include breast cancer,breast carcinoma,Small Breast Epithelial Mucin,SBEM.And then strictly according to the inclusion and exclusion criteria screening,and the inclusion of information collection,the use of QUADAS scale into the literature evaluation,and then extract the data using Meta-Disc 1.4 software for meta-analysis.Evaluate the sensitivity(Sen),specificity(Spe),diagnostic odds ratio(DOR),negative likelihood ratio(Negative LR),positive likelihood ratio(Negative LR),subject operating characteristic curve(SROC)area under curve(AUC)and diagnostic Q index of diagnosis experiment.2.A total of 106 women with with postoperative pathology diagnosed with breast cancer,imaging examination to rule out a second primary tumors at the same time,and have no adjuvant therapy.Through RT-PCR method to detect the expression of peripheral blood SBEM.Analyze all of the relationship between the age composition ratio,TCM syndrome type ratio,SBEM positive expression rate and TCM syndromes were analyzed.Results:1.Meta analysis results Detection of SBEM participants included 15 studies(n = 2106),the ROC plane scatter plot of Meta-Disc 1.4 software was atypical "shoulder arm",the Spearman correlation coefficient of logarithm of sensitivity and specificity was-0.079,P = 0.779,P> 0.05,suggesting thatthere is no threshold effect.Random effect model Meta analysis showed that:The Spe merger= 0.99 [95% CI(0.99,1)]Sen merger = 0.38 [95% CI(0.36,0.36)]+ LR merger = 26.73 [95% CI(14.73,48.53)]-LR merger = 0.62 [95% CI(0.60,0.65)]Are merged = 42.52 [95% CI(23.03,23.03)]SROC AUC = 0.93162.Relationship between SBEN and TCM Syndromes A total of 106 patients with breast cancer were enrolled in this study.Among them,106 cases were female patients and the age section of women with high-risk of breast cancer were41 to 50 years,accounting for 41.51% of the total,compared with the rest of the four groups The difference was statistically significant(P < 0.05).Typing of syndrome differentiation of 106 cases breast cancer patients with syndrome differentiation: sydrome of liver-qi stagnation in 41 cases,accounting for 38.68%,sydrome of accumulation and binding of heat-poison in 17 cases,accounting for 16.04%,sydrome of imbablance of Chong and Ren Channels in 19 cases,accounting for 17.92%,syndrome of deficiency of both qi and blood 9 cases,accounting for 8.49%,12 cases of weakness of the spleen and stomach syndrome,accounting for 11.32%,8 cases of syndrome of yin deficiency of liver and kidney,accounting for 7.55%.The most common type of breast cancer was sydrome of liver-qi stagnation,sydrome of accumulation and binding of heat-poison,sydrome of imbablance of Chong and Ren Channels,compared to the rest of the group was statistically significant(P < 0.05).SBEM positive expression in 54 cases,accounting for 50.94% of all patients;between the syndrome type showed that sydrome of liver-qi stagnation(68.29%)and sydrome of accumulation and binding of heat-poison(64.71%)patients with SBEM positive expression was significantly higher than the other four groups,(P<0.05).There was no significant difference between the other four groups(P> 0.05).Conclusion:1,The specificity of diagnosis of micrometastases in peripheral blood of breast cancermicrometastases in peripheral blood of breast cancer by detection SBEM is high,the sensitivity is relatively low,so that in clinical applications can be combined with serum tumor markers,the traditional imaging and histopathological examination of the results of comprehensive analysis and judgment to provide reference for clinical decision making better.2,The female patients with 41-50 years of age or TCM Syndrome Differentiation for the syndrome type showed that sydrome of liver-qi stagnation,sydrome of accumulation and binding of heat-poison,sydrome of imbablance of Chong and Ren Channels,should be regular physical examination,early detection and early treatment to improve the survival of patients.The recurrence and metastasis risk for the breast cance rpatients with sydrome of liver-qi stagnation,sydrome of accumulation and binding of heat-poison is higher,should be timely review,timely control of the development of the disease in order to extend the survival of patients. |
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