The Value Of Constitution Identification In The Risk Of Colorectal Adenomatous Polyps

Background:Colorectal cancer is one of the most common malignant diseases,and its incidence rate ranks the 3rd among global malignant tumors and mortality rate ranks the 2nd,which is also the first malignant disease of the digestive system in terms of global morbidity and mortality,and seriously threatens people’s life safety.In recent years,with the rapid development of China’s economic level and the increasing westernization of living habits and dietary structure,the incidence of colorectal cancer has been on the rise,and now it has become the second most common malignant tumor in the digestive system and the first in the prevalence rate in China.Obj ective:Research based on colonic polyps in patients with tumor sex constitution identification of traditional Chinese medicine and its SDC2 fecal DNA methylation level,get some early colorectal adenomas sex polyp related physical and genetic,helps improve the efficiency of screening precancerous lesions,also is advantageous to the optimize allocation of medical resources,early screening for CRC risk assessment provides a new direction.Methods:Based on the Quantification Questionnaire for Colorectal Cancer Screening High Risk Factors,a high-risk group of colorectal cancer patients proposed for colonoscopy from May 2019 to January 2020 at Jiangsu Provincial Hospital were opportunistically screened,and the diagnosis of colorectal adenomatous polyps was confirmed by colonoscopy and pathology,and a series of aspects such as body shape and posture,psychology,and living habits of the patients were determined according to the TCM Body Quality Classification Criteria to determine the patients’ attributed The SDC2 methylation level of exfoliated cell DNA was measured in the stools taken before intestinal preparation to determine the negative and positive results of the tested specimens.SPSS24 was used to analyze the correlation between patienf’s age,gender,colonoscopic presentation(including polyp size,single and multiple polyps),pathological type and TCM body type and SDC2 methylation level of fecal DNA.Results:(1)Basic information:A total of 122 patients with CAP were collected in this study,including 75 male patients and 47 female patients,with a ratio of about 1.6:1 and an age of 60.37±10.9 years.(2)The distribution of constitution types was as follows:26(21.3%)with damp and hot substance,25(20.5%)with phlegm and dampness,21(17.2%)with Yang deficiency,and 18(14.8%)with qi deficiency.There were 7 patients with Yin deficiency(5.7%)and 8 patients with Qi stagnation(6.6%).Blood stasis was found in 10 patients(8.2%).Pinghua 6 people,accounting for 4.9%.Special quality 1 person,accounting for 0.8%.(3)SDC2 gene methylation was positive in 41 patients and negative in 81 patients,with an overall sensitivity of 33.6%.Adenomatous polyp>There were 53 patients with 1cm,of which 30 patients were positive for SDC2 gene test,with a sensitivity of 56.6%.Patients with multiple adenomatous polyps are more likely to be tested positive for SDC2 gene than patients with single adenomatous polyps.(4)Patients with humid and hot substance and phlegm and damp substance were more likely to be true positive by SDC2 gene methylation test,while patients with Yang deficiency constitution were more likely to be false negative by SDC2 gene methylation test.(5)The pathological types of adenomatous polyps were tubular adenoma in 87 cases,villous adenoma in 13 cases,villous tubular adenoma in 16 cases,and serrated adenoma in 6 cases.There was no significant correlation between SDC2 gene methylation and physical fitness.Conclusions:(1)CAP are more common in men,with a high incidence between 50 and 70 years of age.(2)In the constitution types of patients with CAP,the proportion of damp and hot matter was 21.3%,and the proportion of phlegm and damp matter was 20.5%.It is inferred that the occurrence of this disease may be closely related to the population with damp and hot matter,phlegm and damp matter,and Yang deficiency body mass.In the early screening of colorectal cancer,we should pay special attention to the people with these three constitutions.(3)SDC2 gene methylation in fecal exfoliated cells was associated with multiple,>Adenomatous polyps of 1cm have certain sensitivity.It has the advantages of convenience and safety in the early screening and diagnosis of CRC,reducing the pain of patients brought by invasive examination,and having good dependence.CRC can be screened in a wide range,so as to achieve the purpose of early diagnosis and early treatment,thus reducing the incidence and mortality of CRC.(4)For patients with humid and hot quality and phlegm and damp quality,the genetic test of fecal exfoliated cells can be recommended for early CRC screening,while for patients with Yang deficiency quality,the genetic test of fecal exfoliated cells is not preferred or the combination of other methods is recommended.