A Study On Correlation Of Mismatch Repair Gene Expression With Tcm Syndrome Types And Clinicopathological Features In Colorectal Cancer

Objective: To study mismatch repair(MMR)gene expression and TCM syndrome types and clinicopathological characteristics(including age,gender,tumor TNM stage,onset site,general pathological type,pathological features of colorectal cancer,CRC)in patients with colorectal cancer(CRC)Histological grading,nerve invasion,vascular invasion,lymph node metastasis and other parameters),in order to provide a certain reference for the clinical prevention and treatment of CRC with integrated traditional Chinese and Western medicine.Methods: A total of 176 CRC patients who were treated in the General Surgery Department of the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from February 1,2021 to February 1,2022 were selected in this study,informed consent was obtained,and general conditions(age and gender),the collection of information on the four diagnosis of traditional Chinese medicine,and the determination of TCM syndrome types,and then collect the postoperative pathological data of patients,including tumor TNM stage,disease site,general pathological type,histopathological type,histopathological grade,neurological Invasion,vascular invasion,lymph node metastasis and MMR gene expression immunohistochemical results.Finally,enter into EXCEL form to establish database,and use SPSS21.0 software for statistical analysis to study the correlation between MMR gene expression and TCM syndrome types and clinicopathological characteristics of CRC patients.Result:1.Among the 176 CRC patients,there were 123 males(69.89%)and 53 females(30.11%),with an average age of 65.94±13.38 years.2.Among the 176 CRC patients,166(94.32%)of the 176 CRC patients had complete MMR gene expression(proficient mismatch repair,p MMR),and 10(5.68%)had the complete loss of MMR gene expression(deficient mismatch repair,d MMR).The deletion rates of MLH1,MSH2,MSH6,and PMS2 genes were 2.84%,1.14%,1.70%,and 3.41%,respectively.3.Among the TCM syndrome types of 176 CRC patients,80 cases(45.45%)of spleen and kidney yang deficiency syndrome,39 cases(22.16%)of liver and kidney yin deficiency syndrome,4 cases(2.27%)of qi and blood deficiency syndrome,and phlegm-dampness syndrome.18 cases(10.23%)were suspended,and 35 cases(19.89%)were diagnosed with stasis poison.Among them,123 cases(69.89%)were false and 53 cases(30.11%)were positive.4.Of the 176 CRC patients,106(60.23%)had the rectum as the most common disease site.The pathological results were mostly ulcer type in 116 cases(65.9%),non-mucinous adenocarcinoma in 156 cases(88.64%),and high-grade in 133 cases(75.57%).Pathologically,136 patients(77.27%)had nerve invasion,127(72.16%)had vascular invasion,and 74(42.05%)had lymph node metastasis.Pathological TNM staging had the largest proportion of patients with stage II and stage III,both of which were 67 cases(38.07% each).In the T stage subgroup: 17 cases(9.66%)in T1 stage,36 cases(10.80%)in T2 stage,92 cases(52.27%)in T3 stage,and 48 cases(27.27%)in T4 stage;in the N stage subgroup: N0 stage 100 cases(56.82%),38 cases(21.59%)in N1 stage,and 38 cases(21.59%)in N2 stage.In the M stage subgroup: 164 cases(93.18%)of M0 stage and 12 cases(6.82%)of M1 stage.5.There was no correlation between MMR gene expression of CRC and TCM syndrome type,gender,age,general pathological type,TNM stage,pathological T stage,lymph node metastasis,nerve invasion,vascular invasion and distant metastasis(P> 0.05).6.There is a correlation between the expression of MMR gene in CRC and the tumor site(P<0.05).There was no significant difference in MMR gene expression between patients with right colon cancer and left colon cancer(P>0.017);MMR gene expression between right colon cancer and rectal cancer,left colon cancer and rectal cancer were all Significant difference(P<0.017).Compared with patients with rectal cancer,MMR gene expression was more common in patients with right-sided and left-sided colon cancers than in patients with rectal cancer.7.There was a correlation between MMR gene expression and histological type of CRC(P<0.05).Compared with colorectal cancer histologically typed non-mucinous adenocarcinoma patients,histologically typed colorectal cancer patients with mucinous adenocarcinoma had more common d MMR gene expression.8.There was a correlation between MMR gene expression and histological grade of CRC(P<0.05).Compared with colorectal cancer patients with low-grade histological grade,MMR gene expression was more common in patients with high-grade histological grade.9.There was no correlation between TCM syndrome types of CRC and gender,age,general pathological type,histological type,histological grade,TNM stage,nerve invasion,vascular invasion,lymph node metastasis and distant metastasis(P>0.05)..10.There is a correlation between TCM syndrome types of CRC and tumor location(P<0.05).Among them,there were significant differences in the distribution of TCM syndrome types of CRC among patients with right colon cancer and rectal cancer,left colon cancer and rectal cancer(P<0.017).Right and right colon cancer patients are more common with spleen-kidney yang deficiency syndrome and stasis toxin internal syndrome,and rectal cancer patients are more common with spleen-kidney yang deficiency syndrome and liverkidney yin deficiency syndrome.11.There is a correlation between TCM syndrome types and pathological T staging of CRC(P<0.05).There were significant differences in pathological T staging between CRC patients with spleen-kidney yang deficiency syndrome and CRC patients with stasis-toxin syndrome(P<0.005).Compared with patients with spleen-kidney yang deficiency syndrome,patients with stasis and toxin internal syndrome are more often manifested in T3-T4 stage.Conclusion:1.The MMR gene expression of CRC has no correlation with TCM syndrome types.The TCM syndromes of p MMR and d MMR colorectal cancer are mainly deficiency syndromes,and spleen and kidney yang deficiency syndromes are the most common among the deficiency syndromes.2.There was no correlation between MMR gene expression of CRC and gender,age,gross pathological type,TNM stage,pathological T stage,lymph node metastasis,nerve invasion,vascular invasion and distant metastasis;it was not related to tumor location and histological type,Histological grades were correlated.Compared with p MMR type patients,d MMR type patients are mostly located in the right and left colon.3.There is no correlation between TCM syndrome types of CRC and gender,age,general pathological type,histological type,histological grade,TNM stage,nerve invasion,vascular invasion,lymph node metastasis and distant metastasis;,There is a correlation between pathological T staging.Left and right colon cancer patients are more common with spleen-kidney yang deficiency syndrome and internal stasis syndrome,while rectal cancer patients are more common with spleen-kidney yang deficiency syndrome and liver-kidney yin deficiency syndrome.Compared with patients with spleen-kidney yang deficiency syndrome,patients with stasis and toxin internal syndrome are more often manifested in T3-T4 stage.