Correlation Between TCM Constitution And Clinical Pathology In Patients With Colorectal Cancer

Objective:To explore the distribution characteristics of TCM constitutions in patients with CRC and the relationship between TCM constitution and clinical pathology,in order to provide theoretical reference for the prevention and treatment of colorectal cancer.Methods:In this study,all patients were admitted to 940 Hospital and Gansu Provincial Hospital of Traditional Chinese Medicine from January 2020 to January 2021.The patients were diagnosed with CRC and underwent surgical treatment.The investigators identified the TCM constitutions of the patients according to the Classification and Determination of TCM Constitutions,and then collected the data of the patients for statistical processing,and finally analyzed the results.The results were analyzed to explore the distribution of TCM constitutions with colorectal cancer and the correlation with clinical pathology.Results:1.General information: A total of 209 patients with CRC were included in the study,including 124 males and 85 females,with a male-to-female ratio of 1.46.There were 16 cases in the young group(younger than 45 years old),91 cases in the middle group(45-65 years old),and 102 cases in the old group(65 years old and above).2.Clinical pathology data: There were 72 patients with left colon cancer,39 patients with right colon cancer and 98 patients with rectum cancer.There were 39 cases of protuberant type,6 cases of infiltrative type,and 164 cases of ulcer type.There were 197 patients with adenocarcinoma,2 with adenosquamous carcinoma,3with squamous carcinoma,and 7 with undifferentiated carcinoma.There were 49 patients with poorly differentiated tumors,113 patients with moderately differentiated tumors,and 40 patients with highly differentiated tumors.There were 109 patients with regional lymph node metastasis and 16 patients with distant metastasis.There were 19 patients with stage I,81 with stage II,93 with stage III,and 16 with stage IV.3.Distribution of TCM constitutions: Among 209 colorectal cancer patients included,there were 32 cases of normal constitution,19 cases of Qi-deficiency constitution,38 cases of Yang-deficiency constitution,17 cases of Yin-deficiency constitution,25 cases of phlegm-dampness constitution,39 cases of damp-heat constitution,27 cases of blood stasis constitution,9 cases of Qi-stagnation constitution,and 3 cases of special constitution.4.There were statistically significant differences in the distribution of Yang deficiency constitution,phlegm dampness constitution,damp-heat constitution and blood stasis constitution in CRC patients(P<0.05).The phlegm-dampness constitution and damp-heat constitution of male patients was 16.13% and 23.39% and that of female patients was 5.88% and 11.76%,indicating that the distribution ratio of phlegm-dampness constitution and damp-heat constitution in male patients was higher than that of female patients.Yang deficiency constitution and blood stasis constitution accounted for 27.41% and 18.82% in female patients and 13.71% and 8.87% in male patients,indicating that the distribution ratio of Yang deficiency constitution and blood stasis constitution in female patients was higher than that in male patients.5.There were statistical differences in the distribution of calmness,Qi-deficiency constitution,Yang-deficiency constitution and damp-heat constitution in CRC patients in different age groups(P<0.05).The normal constitution and dampness and heat constitution in the middle-aged group was 16.48% and 26.37%,and that in the elderly group was 5.88% and 12.75%,indicating that the distribution ratio of normal constitution and dampness and heat constitution in the middle-aged group was higher than that in the elderly group.The Qi-deficiency constitution and Yang-deficiency constitution contents accounted for 14.71% and 25.49% in the elderly group,and4.40% and 13.19% in the middle-aged group,indicating that the distribution ratio of Qi-deficiency constitution and Yang-deficiency constitution in the elderly group was higher than that in the middle-aged group.6.There were statistically significant differences in the distribution of Qi-deficiency constitution and blood stasis constitution in different sites of CRC(P<0.05).The proportion of Qi-deficiency constitution in the right colon cancer was30.77%,and that in the left colon cancer and rectum cancer was 4.17% and 4.08%,indicating that the distribution rate of Qi-deficiency constitution in the right colon cancer patients was higher than that in the left colon cancer and rectum cancer patients.The proportion of blood stasis constitution in left colon cancer was 20.83%and that in the right colon cancer was 5.13%,indicating that the proportion of blood stasis in left colon cancer patients was higher than that in right colon cancer patients.7.There was no significant correlation between TCM constitution and general tumor type,histological type and degree of differentiation in patients with CRC.8.There were statistically significant differences in the distribution of Yang-deficiency constitution and phlegm-dampness constitution in regional lymph node metastasis in CRC patients(P<0.05).Among them,Yang-deficiency constitution and phlegm-dampness constitution accounted for 25.67% and 16.51% in patients with regional lymph node metastasis,and 10.00% and 7.00% in patients without regional lymph node metastasis,indicating that the distribution ratio of Yang-deficiency constitution and phlegm-dampness constitution in patients with regional lymph node metastasis was higher than that in patients without regional lymph node metastasis.9.There was statistical difference in the distribution of Qi-deficiency constitution and Yang-deficiency constitution in distant metastasis in CRC patients(P<0.05).Among the patients with distant metastasis,Qi-deficiency constitution and Yang-deficiency constitution accounted for 25.00% and 43.75%,and 7.77% and16.06% in the patients without distant metastasis,indicating that the distribution ratio of Qi-deficiency constitution and Yang-deficiency constitution in the patients with distant metastasis was higher than that in the patients without distant metastasis.10.There were statistically significant differences in the distribution of normal constitution,Yang-deficiency constitution and blood stasis constitution in clinicopathological stages of CRC patients(P<0.05).Among the patients with stage Ⅰ-Ⅱ,the proportion of normal constitution and blood stasis constitution was 25.00%and 18.00%,and the proportion of normal constitution and blood stasis constitution was 6.42% and 8.26% in stage III-IV,indicating that the distribution ratio of normal constitution and blood stasis normal constitution in the patients with stage Ⅰ-Ⅱ was higher than that in the patients with stage III-IV.The proportion of Yang-deficient constitution in patients with stage III-IV was 23.85%,and that in patients with stage Ⅰ-Ⅱ was 12.00%,indicating that the distribution rate of Yang-deficient constitution in patients with stage III-IV was higher than that in patients with stage Ⅰ-Ⅱ.Conclusions:1.The majority TCM constitution of CEC patients were Yang-deficiency constitution and damp-heat constitution.2.There is correlation between TCM constitution and gender of patients with CRC.The distribution ratio of phlegm-dampness constitution and damp-heat constitution in male patients was higher than that in female patients,and the distribution ratio of Yang-deficiency constitution and blood stasis constitution in female patients was higher than that in male patients.3.The TCM constitution of patients with CRC was correlated with the age of patients.The distribution ratio of normal constitution and dampness-heat constitution in the middle-aged group was higher than that in the elderly group,and the distribution ratio of Qi-deficiency constitution and Yang-deficiency constitution in the elderly group was higher than that in the middle-aged group.4.The TCM constitution of patients with CRC is correlated with the site of the disease.The proportion of Qi-deficiency constitution in the right colon cancer patients was higher than that in the left colon cancer and rectal cancer patients,and the proportion of blood stasis constitution in the left colon cancer and rectal cancer patients was higher than that in the right colon cancer patients.5.There was no significant correlation between TCM constitution and general tumor type,histological type and degree of differentiation in patients with CRC.6.The TCM constitution is correlated with regional lymph node metastasis in patients with CRC.The distribution ratio of Yang-deficient constitution and phlegm-dampness constitution in patients with regional lymph node metastasis was higher than that in patients without regional lymph node metastasis.7.The TCM constitution is correlated with distant metastasis in patients with CRC.The distribution ratio of Qi-deficient constitution and Yang-deficient constitution in patients with distant metastasis was higher than that in patients without distant metastasis.8.The TCM constitution was correlated with clinicopathological stage in patients with CRC.The distribution of normal constitution and blood stasis constitution was higher in patients with stage Ⅰ-Ⅱ than in patients with stage III-IV,and the distribution of Yang-deficiency constitution was higher in patients with stage III-IV than in patients with stage Ⅰ-Ⅱ.