An Correlation Study Between TNM Syndromes Of Breat Cancer And Molecular Typing & Biochemical Indices

ObjectivesExplore the correlation between TCM syndromes of breast cancer,molecular typing,and biochemical indicators,and further explore the distribution characteristics and evolution of TCM syndromes in breast cancer patients before,after,and during the chemotherapeutic period.The purpose of this study is to explore from the perspective of TCM The incidence,progression and outcome of breast cancer(milk rock),combining elements of TCM syndromes with molecular typing,tnm staging,histological grading,dietary factors,and biochemical indicators to reveal their internal correlation to guide clinical treatment.Methods(1)Literature research: This study started with the analysis of the ancient literature on the etiology,transmission and formation of TCM breast cancer(breast cancer),and based on this and the reference standards for TCM diagnosis of breast cancer and the current standardized research on TCM syndromes,etc.The TCM syndrome types that can be used for breast cancer clinical research provide the basis for the subsequent research work on the correlation of TCM syndromes with molecular typing and biochemical indicators.(2)Clinical research: The clinical research passed the "Breast Cancer Clinical Information Collection Form"(preoperative,postoperative,and peri-chemotherapy period).From March 2019 to January 2020,the Department of Breast Cancer I of Nanchang Third Hospital Breast puncture biopsy diagnosed with breast cancer patients(a total of 102 cases)to investigate,collect information on the four stages of traditional Chinese medicine diagnosis,molecular typing(immunohistochemistry),histological grading,TNM staging clinical biochemical indicators and other related aspects of breast cancer patients at different stages According to the diagnostic criteria of traditional Chinese medicine,the collected information of the four clinics will be combined with traditional Chinese medicine syndrome differentiation,and the relationship between the preoperative TCM basic syndromes and the molecular typing of breast cancer(immunohistochemistry),TNM staging,histological grading and dietary factors will be analyzed.;Then descriptive statistics of the basic TCM syndromes and corresponding clinical biochemical objective indicators of the three stages of breast cancer(preoperative,postoperative,and perichemotherapy),and logistic regression analysis to study the basic TCM syndromes and clinical biochemical objective of breast cancer The correlation between indicators,the degree of correlation is expressed by the OR value.ResultsLiterature research: Breast cancer(milk rock)is actually a kind of carbuncle that is prone to occur in the breast,like a cave,and its specific formation process is similar to carbuncle.Important.In addition,exogenous evidence is an important cause of milk rock formation.In addition to emotional factors in internal injuries,dietary habits such as milk and ice are also important causes of internal injuries affectingmilk rock formation.At the same time,ten top available The basic syndrome types of traditional Chinese medicine for breast cancer clinical research are blood deficiency syndrome,blood stasis syndrome,surface syndrome,qi deficiency syndrome,qi depression syndrome,yin deficiency syndrome,real heat syndrome,yang deficiency syndrome,phlegm dampness syndrome,and cold syndrome And adopt the form of combination of basic syndromes to carry out TCM syndrome differentiation for each patient to ensure the accuracy of the syndrome type and the objectivity of the research in the follow-up clinical research to the greatest extent.Clinical research:(1)The distribution of preoperative TCM basic syndromes in the molecular classification of breast cancer: Lunimal A type: Qi Yu(91.3%),solid heat(69.6%);Lunimal B1 type: Qi Yu(78.8%),Solid heat(69.7%);Lunimal B2 type: Qi depression(78.6%),solid heat(71.4%);HER-2overexpression type: Qi depression(93.3%),Qi deficiency and phlegm(each(66.7%);Sanyin type(basal-like type): Qi depression(94.1%),phlegm dampness,solid heat and blood stasis(64.7% each).(2)The distribution of preoperative TCM basic syndromes in tnm staging of breast cancer: stage I: Qi depression(83.9%),solid heat and phlegm(67.7% each);stage II: Qi depression(87.7%)),Real heat(7l.9%);Phase III: Qi depression(85.7%),blood stasis(78.6%).(3)The distribution of preoperative TCM basic syndromes in the histological grade of breast cancer: due to the small sample size of level1,it is not counted;level 2: Qi depression(87.9%),real heat(69%);Grade 3: Qi depression(83.7%),phlegm and heat(65.1% each).(4)The relationship between the basic syndromes of traditional Chinese medicine and molecular typing(immunohistochemistry),TNM staging,and histological classification before operation: chi-square test shows that the two groups of Lunimal A and non-Lunimal A types haveonly Yang deficiency syndrome There is a difference in the composition ratio P)<(0.05,which is statistically significant.Lunimal B1 type and non-Lunimal B1 type,Lunimal B2 type and non-Lunimal B2 type,HER-2overexpression type and non-HER-2 overexpression type,Sanyin There is no difference in the constituent ratios of basic syndromes of the type and non-three-yin type and the ten types of traditional Chinese medicine P)>(0.05,so it is not statistically significant.The two groups of HER-2(+)and HER-2(-)have only Qi deficiency syndrome.There is a difference in the composition ratio P0.05()<,which is statistically significant.In the TNM staging and histological classification,there is no difference in the composition ratio of the basic syndromes of each group and the ten categories of TCM P)>(0.05,so it is not statistically significant.(5)The distribution of pre-operative TCM basic syndrome types in dietary factors: milk: Qi Yu(86.7%),phlegm(66.7%),real heat(63.3%),ice: Qi Yu(84.8%)%),Blood stasis,solid heat and phlegm and dampness(60.6% each),spicy diet: Qi depression(81.6%),real heat(65.8%),blood stasis(57.9%).(6)The relationship between pre-operative TCM syndromes and dietary factors: The composition ratio of milk and non-milk,ice and non-ice products only differs from the actual cold syndrome P)<(0.05,so it is statistically significant.Compared with the non-spicy and greasy diet,only the composition ratio of Yang deficiency syndrome is different P)<(0.05,so it is statistically significant.Milk and non-milk,ice and non-ice products,spicy and greasy diet and non-spicy and greasy diet are the same as the rest of TCM.There is no difference in the composition ratio of syndromes P)>(0.05,so it is not statistically significant.(7)The distribution characteristics of TCM syndromes before,after,and during the peri-chemotherapy period: the average age of breast cancer patients(52.25± 10.944)years old,40-50 years old is the risk age group of breast cancer,the most patients(37.3%)The three types(preoperative,postoperative,and perichemotherapy)of the ten types of basic syndromes ranked in the top four are,preoperatively: Qi depression(86.2%),real heat(67.6%),blood stasis(60.8%)),Phlegm and dampness(56.9%);postoperative: phlegm and dampness(68.6%),qi deficiency(65.7%),blood stasis(53.9%),qi depression(37.3%);peri-chemotherapy period: qi deficiency(75.5%),phlegm Wetness(59.8%),Qi depression(51.0%),blood deficiency(42.2%).(8)Correlation study of basic TCM syndromes of breast cancer and biochemical indicators: blood deficiency syndrome:OR value(BExp))(from high to low is in turn EOS decline(9.578),RDW rise(0.418),RBC rise(0.169);blood stasis syndrome:OR value))((BExp from high to low is NEUT rise(11,093),Hb rise(0.423);Table evidence: OR value))((BExp is RBC rise(15.361);Qi deficiency syndrome: OR value))((BExp from high to low are TG rise(0.405),MCHC rise(0.297),NEUT rise(0.291),RBC fall(0.174),Qi depression card: OR value))((BExp From high to low,GGT rises(0.120),complement C1 q falls(0.094),EOS% falls(0.081),NEUT falls(0.062),Yin deficiency syndrome: OR value))((BExp is CRP Rise(0.310),real heat:OR value))((BExp is LDH rise(0.523);Yang deficiency syndrome:OR value))((BExp high to low is RBC decline(11.732),HBDH rise(0.266)),Complement C1 q rise(0.229);Phlegm-dampness syndrome:OR value))((BExp from high to low is Apo B rise(6.939),RDW rise(2.339);cold syndrome:OR value))((BExp From high to low are TG rise(4.193),CK rise(0.174),Hcy rise(0.056).Conclusions(1)In the relationship between preoperative breast cancer basic syndrome types and molecular typing,Lunial A type is related to Yang deficiency syndrome,HER-2(+)is related to Qi deficiency syndrome,Luminal B2 type and HER-2 overexpression type may be related to Qi deficiency syndrome.In the relationship between the basic syndrome of traditional Chinese medicine and dietary factors before breast cancer surgery,milk and ice products are related to real cold syndrome,and spicy diet is related to Yang deficiency syndrome.(2)In the relationship between the basic TCM syndromes of breast cancer and biochemical indicators,the rise of NEUT is a significant indicator of the blood stasis syndrome of breast cancer;the rise of RBC is a significant indicator of the manifestation of breast cancer;the decrease of RBC is the significant impact of the syndrome of Yang deficiency Index;Apo B increase and RDW increase are significant indicators of breast cancer phlegm and dampness syndrome;TG increase is a significant indicator of breast cancer cold syndrome.