| Objective:The experiment is based on the deep study on classical medical books and modern TCM literature, combining with clinical research early days. It is first believed that"damp-heat stagnancy toxin"is the key of TCM etiology and pathogenesis of colorectal carcinoma. It also brings forward the clinical presentations syndrome of"damp-heat stagnancy toxin"of colorectal carcinoma and constitutes its diagnostic criteria in TCM, which refreshes the differential syndrome of TCM. Third, it has a united test of relevant tumor markers(CEA,CA242,CA19-9 and CK20) about"damp-heat stagnancy toxin"syndrome operating patients on tumor idiopathic place,tumor peripheral lymphnodes and normal epithelium tissues beside tumor,so that it further identifies the special expression of relevant tumor markers on"damp-heat stagnancy toxin"syndrome of colorectal carcinoma,which can guide clinic and judge prognosisMethod:1 Theoretical ResearchBasing on the deep study on classical medical books and modern TCM literature and according to the theory of TCM collateral diseases, we puts forward the scientific hypothesis that"damp-heat stagnancy toxin"is the key of etiology and pathogenesis in TCM and constitutes that"damp-heat stagnancy toxin"syndrome is the main clinical presentations of TCM differential typing on colorectal carcinoma by collection,arrangement and abstraction, also in combination with forward clinical research.2 Clinical Research①The clinical research constitutes diagnostic criteria of TCM"damp-heat stagnancy toxin"syndrome of colorectal carcinoma, which is based on studying colorectal carcinoma patients, according to the basic theory of TCM , combining with clinical presentations of the patients, and refreshing differential typing of TCM on colorectal carcinoma.②Through the method of immunohistochemistry ,we have an united test of relevant tumor markers(CEA,CA242,CA19-9 and CK20) about"damp-heat stagnancy toxin"syndrome operating patients on tumor aidiopathic place,tumor peripheral lymphnodes and normal epithelium tissues beside tumor, so as to further identify tumors special expression, tumors stage, also in combination with clinical materials and prognosis to guide clinic and develop anonym and monitoring after operation.③Using the method of immunohistochemistry and RT-PCR ,the experiment respectively studies the expression of protein CK20 and CK20mRNA in different tissue, which is from"damp-heat stagnancy toxin"syndrome operating patients of colorectal carcinoma. Through its special expression, it guides clinic and develop anonym and monitoring after operation.Results1 Results of theoretical researchIt first puts forward and elaborates the theoretical frame and foundation that how"damp-heat stagnancy toxin"clinical presentations,pathogenesis of colorectal carcinoma forms. It thinks that"damp-heat stagnancy toxin"syndrome is the key of pathogenesis of colorectal carcinoma in TCM. It first brings forward"damp-heat stagnancy toxin"syndrome in differential typing of colorectal carcinoma.2 results of clinical research①We first put forward that the differential treatment is divided into four syndromes: 1) damp-heat stagnancy toxin syndrome 2)Yang deficiency of the spleen and kidney syndrome 3) Yin deficiency of liver and kidney syndrome 4) deficiency of qi and blood syndrome. Among them,"damp-heat stagnancy toxin"syndrome is the main type. We also constitute the diagnostic criteria of"damp-heat stagnancy toxin"syndrome of colorectal carcinoma in TCM. We have a differential typing in TCM among 102 colorectal carcinoma patients in hospital from 2006.6 to 2007.9 .Among them, damp-heat stagnancy toxin: 63; Yang deficiency of the spleen and kidney: 11; Yin deficiency of liver and kidney: 13; deficiency of qi and blood: 15; damp-heat stagnancy toxin syndrome is 61.8%.②The experimental research on the expression of protein CEA in different tissues of"damp-heat stagnancy toxin"syndrome operating patients suffered from colorectal carcinoma .It has obvious expression that CEA of tumor idiopathic place from"damp-heat stagnancy toxin"syndrome patients of colorectal carcinoma compared with other groups. CEA is more sensitive for colorectal carcinoma. Because CEA has lower specific, it can't be the select norm. So it is only used to monitor the patient of tumor and judge the therapeutic effectiveness③The experimental research on the expression of protein CA242 in different tissues of"damp-heat stagnancy toxin"syndrome operating patients suffered from colorectal carcinoma For"damp-heat stagnancy toxin"syndrome patients suffered from colorectal carcinoma, it highly expresses that protein CA242 in colorectal carcinoma tissues and seldom expresses in benign tissues. Furthermore,CA242 is the positive expression in peripheral lymphonotes of tumor. Its heightening indicates the micromitastasis of tumor.④The experimental research on the expression of protein CA19-9 in different tissues of"damp-heat stagnancy toxin"syndrome operating patients suffered from colorectal carcinoma.For"damp-heat stagnancy toxin"syndrome patients of colorectal carcinoma, protein CA19-9 highly expresses in colorectal carcinoma tissues. It is more sensitive for colorectal carcinoma and seldom expresses in benign tissues. The research shows that the positive rate could be obviously increased by parallelly and unitedly testing CEA,CA242 and CA19-9. It is better than doing only one test, using their positive complementarities.⑤The experimental research on the expression of CK20 and CK20mRNA in different tissues of"damp-heat stagnancy toxin"syndrome operating patients suffered from colorectal carcinoma.CK20 seldom expresses in benign tissues but highly expresses in colorectal carcinoma tissues. For"damp-heat stagnancy toxin"syndrome patients of colorectal carcinoma,it is more sensitive than traditional pathomorphology test that we use the method of RT-PCR to test micromitastasis of lymphonote of colorectal carcinoma tissues, so we can give a exact prognostic judgment.Conclusions:①The research testifies that"damp-heat stagnancy toxin"is the key of etiology and pathogenesis of colorectal carcinoma in TCM.②Establishing the clinical presentations syndrome of"damp-heat stagnancy toxin"of colorectal carcinoma in TCM and its diagnostic criteria.③Clarifying the obvious expression of CEA in tumor idiopathic place from"damp-heat stagnancy toxin"syndrome patients of colorectal carcinoma compared with other groups. CEA is more sensitive for colorectal carcinoma but has lower specific④Clarifying that CA242 is highly expresses in colorectal carcinoma tissues and seldom expresses in benign tissues from"damp-heat stagnancy toxin"syndrome patients of colorectal carcinoma.⑤For"damp-heat stagnancy toxin"syndrome patients of colorectal carcinoma , protein CA19-9 highly expresses in colorectal carcinoma tissue and seldom expresses in benign tissues. CA19-9 is more sensitive for colorectal carcinoma.⑥CK20 seldom expresses in benign tissues but highly expresses in colorectal carcinoma tissues. It is more sensitive than traditional pathomorphology test that we use RT-PCR to test micromitastasis of lymphnodes of colorectal carcinoma tissues, so we can give an exact prognostic judgment.⑦In this research, we found that the analysis on the cause and pathogenesis of"damp-heat stagnancy toxin"syndrome about colorectal carcinoma will contribute to the clinical differentiation in TCM. Sensibility and specific of tumor markers and positive diagnostic rate could be obviously increased by unitedly testing four kinds of tumor markers CEA,CA242 and CA19-9. It is better at judging neoplasm staging and prognosis and helpful for increasing diagnostic accuracy of colorectal carcinoma.
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