An Objectification Study Of Breast Cancer Tongue Image Based On Color Model

Objective:Taking the tongue image characteristics of breast cancer patients as the main research content,the characteristics and rules of the tongue image of breast cancer patients with different TCM syndromes,different clinical stages and different molecular subtypes were analyzed,and the rules were expressed with data indicators to provide objective data for the tongue image of breast cancer.Methods:Breast cancer patients who received medical treatment in the Hematology and Oncology Department of Bejing University of Chinese Medicine,Dongzhimen Hospital,from June 2019 to January 2021 and participated in the National Key Research and Development·Program of TCM Modernization Research Key Project·TCM Intelligent Tongue Diagnosis System R&D Project(2017YFC1703300)and met the inclusion criteria of this study were selected as the subjects.The basic information,symptoms and signs,pathological data and other information of the patients were collected.According to the clinical informations which includ the basic information of patients,symptoms and signs,pathological data and other informations of patients to judge TCM syndrome,clinical stage and molecular subtype.The digital tongue diagnosis instrument TFDA-1 is used to take pictures of the tongues of patients.Using Matlab as image processing system and using RGB and HSV color model measuring program developed by Professor Cai Yiheng's team of Beijing University of technology to measure the color parameters of the pictures.The parameters include:R(the bigger R,the more red component),G(the bigger G,the more green component),B(the bigger B,the more blue component);H(the greater difference in H,the greater difference in color),S(the bigger S,the darker of the color,otherwise the lighter),V(the bigger V,the brighter of the color,otherwise the dimmer).In addition,calculating the following parameters based on R,G and B:the purple coefficient P(the greater the proportion of P,the more purple of the color),and the yellow coefficient Y(the greater the proportion of Y,the more yellow of the color).In order to distinguish the tongue image parameters of tongue color and tongue coating color,"tongue*" and "tongue coating*" are used to represent the parameters of tongue image color in this paper.For example,"tongue V" means "the brightness of tongue color" and "tongue coating V" represents "the brightness of tongue coating color".SPSS 20.0 statistical software was used to analyze and compare the tongue image color parameters of breast cancer patients with different TCM syndromes,different clinical stages and different molecular subtypes.Results:(1)Objective results of tongue manifestation of breast cancer patients with different syndromes?Objective parameters of tongue color:There are no significant differences in tongue G and tongue S(P>0.05);There are significant differences in tongue R,tongue B,tongue P.tongue H and tongue V(P<0.05 or P<0.01).The details are as follows:Compared with Qi deficiency syndrome and phlegm-dampness syndrome,tongue H of Qi stagnation syndrome and blood stasis syndrome increased,indicating that the difference of tone between each group was obvious.Tongue B and tongue P increased,indicating that the blue component of tongue color in Qi stagnation syndrome and blood stasis syndrome was more,and the tongue color was more purple.The increase of tongue H indicates that the difference of tone between each group is obvious.The increase of tongue R,tongue P and tongue V indicates that the red component of the tongue color in the heat toxin syndrome is more,and the tongue color is closer to the falling red and the brightness is higher.The tongue H in Yin deficiency syndrome increased,indicating that the difference of tone between each group was obvious.The tongue R,tongue B,tongue P and tongue V were all increased,indicating that the red and blue components of the tongue color in Yin deficiency syndrome were more,and the tongue color was closer to purple and the brightness was higher.Compared with Qi deficiency syndrome,the tongue H in phlegm-dampness syndrome increased,indicating that the difference of tone between the two groups was obvious.Tongue P increased,indicating that the tongue color in phlegm-dampness syndrome was closer to purple.?Objective parameters of tongue coating color:There are no significant differences in tongue coating G and tongue coating B(P>0.05);There are significant differences in tongue coating R,tongue coating Y,tongue coating H,tongue coating S and tongue coating V(P<0.05 or P<0.01).The details are as follows:Compared with Qi deficiency syndrome,tongue coating H of the other five groups decreased,indicating that the color of the tongue coating in each group was significantly different.Tongue coating R,tongue coating Y and tongue coating V in Qi stagnation syndrome,heat toxicity syndrome and blood stasis syndrome increased,indicating that the red component of the tongue coating color in Qi stagnation syndrome,heat toxicity syndrome and blood stasis syndrome was more,while the color of the tongue coating was more yellow and the brightness was higher.At the same time,the lower tongue coating S in phlegm-dampness syndrome indicates the lower color saturation.Compared with Qi stagnation syndrome,tongue coating H in phlegm-dampness syndrome,blood stasis syndrome and Yin deficiency syndrome increased,while the tongue coating Y decreased,suggesting that the color difference between each group was obvious,and the color of the tongue coating in Qi stagnation syndrome was more yellow.In addition,the tongue coating S in phlegm-dampness syndrome decreased,indicating that its color saturation was lower.Compared with heat toxin syndrome,tongue coating H in phlegm-dampness syndrome,blood stasis syndrome and Yin deficiency syndrome increased,while tongue coating Y decreased,suggesting that there was a significant difference in the color of the tongue coating among each group,but the color of the tongue coating in heat toxin syndrome was more yellow.In addition,the decrease of tongue coating R,tongue coating S and tongue coating Vin phlegm-dampness syndrome indicates that the red component of the tongue coating is less,the saturation is low and the color is dull.Compared with phlegm-dampness syndrome,tongue coating H and tongue coating S in blood stasis syndrome and Yin deficiency syndrome were increased,suggesting that the color difference between each group was obvious,and the color of the tongue coating in phlegm-dampness syndrome was lighter.(2)Objective results of tongue manifestation of breast cancer patients at different stages?Objective parameters of tongue color:There are no significant differences in tongue R,tongue G,tongue B,tongue H,tongue S and tongue V among breast cancer patients at different stages(P>0.05);There is significant difference in Tongue P(P<0.05).The details are as follows:Compared with stage ? and stage ?,the tongue P of breast cancer patients at stage ? was increased,suggesting that the tongue color of stage ? was more purple.?Objective parameters of tongue coating color:There are no significant differences in tongue coating G,tongue coating B,tongue coating Y,tongue coating H and tongue coating S among breast cancer patients at different stages(P>0.05);There are significant differences in tongue coating R and tongue coating ?(P<0.05).The details are as follows:Compared with stage ?,the tongue coating R and tongue coating V of breast cancer patients at stage ? and stage ? increased,suggesting that the color of the tongue coating of breast cancer contained less red content and lower brightness.(3)Objective results of tongue manifestation of breast cancer patients with different molecular subtypes?Objective parameters of tongue color:There are no significant differences in tongue R,tongue G,tongue B,tongue H,tongue S and tongue V among different Luminal types(P>0.05).?Objective parameters of tongue coating color:There are no significant differences in Tongue coating G,Tongue coating B,Tongue coating Y,Tongue coating H and Tongue coating S among different molecular subtypes(P>0.05);There are significant differences in tongue coating R,tongue coating V(P<0.05).The details are as follows:Compared with the Her2 positive type and the Triple negative type,tongue coating R and tongue coating V of Luminal A and Luminal B were increased,suggesting that the receptor-positive of breast cancer patients contained more red components and had higher brightness.Conclusions:(1)Among different syndromes,RGB and HSV color models can reflect the objectification characteristics of the tongue image of breast cancer with different syndromes to a certain extent.Most objective parameters can restore the clinical perspective of TCM syndrome differentiation,and are consistent with the TCM theory of breast cancer.(2)At clinical stages,tongue P,tongue coating R and tongue coating V can reflect the tongue color and tongue coating color of breast cancer at different stages,which can provide objective reference basis for tongue characteristics of breast cancer at different stages to a certain extent.(3)In molecular subtypes,tongue coating R and tongue coating V can reflect the tongue coating color of receptor-positive and receptor-negative breast cancer patients,which can provide objective reference basis for the tongue coating color characteristics of receptor-positive and receptor-negative breast cancer patients to a certain extent.