| Objective:This project aims to study the oral Fusobacterium nucleus and the tongue picture of patients with recurrence and metastasis of colorectal cancer who meet the criteria for enrollment more than 1 year after radical resection,to explore the distribution of oral Fusobacterium nucleus,objective changes in tongue picture,and colorectal The correlation of postoperative recurrence of cancer will provide prospective clues for the prevention,diagnosis and treatment of recurrence and metastasis of colorectal cancer after radical resection,and provide new ideas for the diagnosis and treatment of malignant tumors of the digestive tract and other systems.Methods:From May 2020 to December 2020,20 patients with recurrence after radical resection of colorectal cancer for 1 year or more,20 patients without recurrence and 20 healthy controls were collected in the ward and outpatient department of Jiangsu Provincial Hospital of Traditional Chinese Medicine.First take pictures of their tongues,then scrape their tongue coatings,collect saliva,and then quantitatively study their tongues through RGB mode,use PCR technology to detect the expression of oral Fusobacterium nucleatum,and analyze the colorectal correlation of tongue picture and oral Fusobacterium nucleatum in patients with recurrence and metastasis more than 1 year after cancer surgery,non-recurrence and metastasis,and healthy people.Result:(1)Tongue quality of RGB value characteristics:pale tongue G value,B value,G value accounted for the highest,red crimson tongue R value accounted for the highest value,B value,B value accounted for the lowest;purple tongue R value,R value The proportion is the lowest.(2)RGB value characteristics of tongue fur:thick white and greasy fur has the highest proportion of B and B values,and the lowest proportion of R value,indicating that thick white and greasy fur is the whitest;thin white fur has the lowest proportion of G,indicating that thin white fur is the most purple,which may be affected The B value of thick yellow greasy coating is the lowest,indicating that thick yellow greasy coating is the yellowest.Compared with thin yellow fur,the R+G+B value of thick yellow and greasy coating is getting larger and larger(P<0.01),which means that as the thick and greasy tongue coating decreases,the R+G+B value will increase.(3)Changes in tongue picture of patients in different groups:①Tongue quality:early and mid-term(non-recurring group)colorectal cancer patients with pale red tongue(50)%;advanced(recurring group)colorectal cancer patients with purple tongue(30%)and Red tongue(25%)is more common;while in the healthy control group,light red tongue is more common(75%).The tongue quality of patients in the recurrence group was quite different from that of the non-recurring group(P<0.05).The tongue quality of patients in the recurrence group was also significantly different from that of healthy people(P<0.05),while the tongue quality of patients in the non-recurring group was significantly different(P<0.05).There was no significant difference between tongue quality and healthy people(P>0.05).Quantitative research found that the R,G,and B values of the tongue in the relapsed group were significantly different from those in the healthy control group(P<0.05).The R,G,and B values of the tongue in the non-relapsed group were compared with those in the healthy control group.There is no difference(P>0.05).②Tongue coating:Thin white coating(35%)is more common in early and mid-term(non-recurring group)colorectal cancer patients;thick white and greasy coating(30%)is more common in patients with advanced colorectal cancer(recurrence group);thin white coating is common in healthy people(70%)more common.The tongue coating of patients in the recurrence group was significantly different from the tongue coating of the non-recurring group and the healthy control group(P<0.05),while the tongue coating of the non-recurring group was not significantly different from that of the healthy control group(P>0.05).The quantitative study found that there were significant differences in the R/R+G+B,G,and B values between the relapsed group and the non-relapsed group(P<0.05).(4)The effect of TCM syndromes of colorectal cancer on tongue appearance:①Tongue quality:Spleen deficiency syndrome is more common in patients with colorectal cancer,a total of 19 cases,and the tongue quality is more common in pale red tongue and red tongue,accounting for 47.37%and 47.37%respectively.26.32%;in patients with damp-heat syndrome,red tongue and red crimson tongue are more common,accounting for 57.14%and 42.86%;in Qi-blood deficiency syndrome,mostly pale tongue and light red tongue,each accounting for 37.5%;and purple Tongue is seen in patients with blood stasis and internal stop syndrome.Quantitative research found that among the various syndrome types,the R value of blood stasis internal stop syndrome accounted for the least(P<0.01)and the B value accounted for the highest proportion(P<0.01);while the damp-heat syndrome had the highest proportion of R value(P<0.01),the B value accounted for the lowest proportion(P<0.05).②Tongue coating:among 19 patients with spleen deficiency syndrome,thin white coating was the most common,accounting for 31.58%,followed by thin yellow coating,accounting for 26.31%;thick yellow greasy coating was common in 7 patients with damp-heat syndrome,accounting for 71.42%;8 cases of qi and blood deficiency In patients,thin white fur,thin white and greasy fur,thick white and greasy fur,thin and thick yellow fur can be seen;while in blood stasis,the main manifestations are thick white and greasy fur and thick yellow and greasy fur.Quantitative research found that the R value of tongue coating in patients with spleen deficiency syndrome was significantly higher than that in patients with damp-heat syndrome and blood stasis syndrome(P=0.001<0.01,P=0.009<0.01).(5)Analysis of the detection rate of oral Fusobacterium nucleatum:1 case of Fusobacterium nucleatum was detected in the normal healthy population,accounting for 5%of the number of patients in this group;14 cases of Fusobacterium nucleatum were detected in the recurrence group,accounting for 70%;The detection rate of Fusobacterium nucleatum in the non-relapsed group was 4 cases,accounting for 20%of the total number of cases.(6)Correlation between oral Fusobacterium nucleatum and tongue coating:greasy coating is more common in the tongue coating of patients with oral Fusobacterium nucleatum,and white greasy coating is significantly more than yellow greasy coating.There are 11 cases of white greasy coating and yellow greasy coating.A total of 7 cases;it can also be found that thick moss is significantly more than thin moss;11 cases of thick moss and 8 cases of thin moss.Conclusion:(1)In the RGB mode,the RGB values of the tongue images of patients with recurrence and metastasis and non-recurrence and metastasis 1 year or more after radical resection of colorectal cancer were measured.It was found that the tongue of the patients in the non-recurrence group was light red tongue with thin white coating;the tongue of the patients in the recurrence group was more common.Purple tongue is more common with thick white greasy fur;and has different RGB values,which is different from its tongue image,which shows that using RGB mode to quantify tongue image has clinical application value.(2)The detection rate of oral Fusobacterium nucleatum in patients with colorectal cancer recurrence after surgery was much higher than that of the healthy group and non-recurrence group(P<0.05);while patients with colorectal cancer who did not relapse after surgery had healthy oral Fusobacterium The population difference is not big(P<0.05).(3)The distribution of oral Fusobacterium nucleatum is related to the thickening and greasy tongue coating.Therefore,our research results suggest that the detection of oral Fusobacterium nucleatum and the thick white greasy coating of purple tongue may be one of the objective indicators of recurrence after colorectal surgery. |
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