| BackgroundColorectal cancer is one of the worlds most common cancer, Early disease is often without any clinical symptoms,many patients are unlikely to cause enough attention,most are already diagnosed with advanced, lost valuable opportunities for radical surgery, short-term survival is thus the mortality rate in the forefront of various types of cancer.Currently, we determine the prognosis and select the appropriate treatment of patients with colorectal cancer is mainly based on the patient’s pathological staging, but these indicators are still inadequate staging, hast as the only guide treatment and prognosis standards.Therefore, early recognition of the presence or absence of metastasis, the transfer method and scope for clinical diagnosis, treatment and prognosis is very important.An important reason for the poor prognosis for most patients with colorectal cancer are:Patients are diagnosed before accepting standardized comprehensive treatment, the tumor had already taken place in all kinds of ways to a wide range of micro-metastases.In recent years, with the rapid development of molecular biology techniques, about colorectal cancer micro metastases are endless studies, for which specific marker studies currently surviving in the controversy associated with this study selected two markers of colorectal cancer hope can come up with colorectal cancer micro metastases correlation.Chinese medicine has a long history, we have studied show that Jiawei Huangqi Guizhi Wuwu Tang can significantly reduce the oxaliplatin peripheral nerve toxicity, but its micro-metastasis in colorectal surgery markers research has yet to see the impact of this study is to deepen the study on the basis of the original study, the mechanism of tumor Integrative Medicine has the advantage of exposition, hoping to provide a basis for the introduction of Chinese traditional medicine treatment of colorectal cancer patients standardization program.ObjectivesCorrelation of expression CK20mRNA and GCCmRNA clinical stage colorectal cancer patients, and thus indirectly verify the colorectal cancer micro metastases its relevance.While observing Jiawei Huangqi Guizhi Tang with oxaliplatin-containing chemotherapy treatment of colorectal cancer patients, dynamic observation of expression related indicators (CK20mRNA and GCCmRNA) after treatment, and its role in the mechanism of aspects to be explored.MethodThe study is divided into two parts, the first part is to verify the relevance, namely micro-metastasis CK20mRNA、GCCmRNA expression and expression of CTCs.Select the TCM Oncology of Anhui Provincial Hospital, Cancer Chemotherapy Oncology of Anhui Provincial Hospital of colorectal cancer patients in40cases,patients were rows of radical resection patients, patients were required to clear the peripheral blood collected, stored in a refrigerator at-80degrees tested, expression lines RT-PCR detection of serum CK20mRNA with GCCmRNA will marker expression and pathological staging of patients after surgery correlation analysis.The second part is to verify flavored Jiawei HuangQi Guizhi Wuwu Tang on serum CK20mRNA,GCCmRNA expression in colorectal cancer patients, the side effects of micrometastases and thus indirectly on verification. Validation correlation, while the specimens in our department library20patients with colorectal cancer and20cases from Cancer Chemotherapy Oncology of the Hospital of Anhui Province the first cycle of chemotherapy in patients with2、4、6, where the patient is treated in our department, patients outside the hospital as the control group, the expression was detected by before the first cycle of chemotherapy2、4、6CK20mRNA, GCCmRNA dynamic observation of each chemotherapy cycle related changes in markers, tumor markers were compared in patients with changing circumstances.Meanwhile two groups were compared in peripheral neurotoxicity, gastrointestinal reactions change, bone marrow suppression, draw statistical conclusions.Results1.In CK20mRNA, GCCmRNA and relevance of micro metastases in a total of40cases, a total of19cases of positive expression CK20mRNA total positive rate of47.5%,22cases of positive expression GCCmRNA total positive rate of55%, while the selected10cases in the peripheral blood of healthy volunteers showed no expression CK20mRNA and GCCmRNA. Statistical analysis showed that, CK20mRNA and GCCmRNA expression and colorectal cancer TNM stage, tumor size, degree of differentiation, with or without thrombosis and lymph node metastasis, and the primary site of the tumor, the patient’s age and gender. Therefore, the expression can be considered as long as there are two markers in the peripheral blood of patients, we can confirm the presence of CTCs in peripheral blood of patients, the conclusion can be proved with GCCmRNA CK20mRNA as specific tumor markers for the detection of peripheral blood CTCs, and10cases of healthy people showed no expression of two markers can further prove expression was significantly associated with postoperative colorectal cancer micro-metastases two markers.In all the above cases,retrospective follow-up study found that the ultimate expression of positive cases CK20mRNA(a total of19cases)in the number of cases appears recurrence and distant metastasis was12cases, CK20mRNAexpressnegative cases(a total of21cases)in number of cases,6cases of recurrence and metastasis occur; GCCmRNA express positive cases(a total of22cases)the number of cases appears recurrence and distant metastasis was14cases, GCCmRNA express negative cases(a total of18cases)and the recurrence the number of cases of distant metastases in5cases.Statistical studies have shown that patients with positive expression and GCCmRNA、CK20mRNA final appearance is closely related to recurrence and distant metastasis, which further confirmed that the two can be used as markers to detect micro-metastases in colorectal surgery-specific marker.2. Against CK20mRNA、GCCmRNA in the treatment group and the control group after6cycles of systemic chemotherapy, the average number of copies of the two markers compared to previous chemotherapy, were seen significantly lower The difference was statistically significant (p<0.05). And each cycle of chemotherapy treatment group and the control group, treatment group, slightly better than the control group, but no significant difference between the two (p>0.05). Thus, Jiawei Huangqi Guizhi Wuwu Tang although no micro-metastasis in colorectal cancer significantly inhibiting effect, but in combination with chemotherapy, The effects is better than chemotherapy alone.3.In the prevention of oxaliplatin peripheral nerve toxicity, the treatment group and the control group, the proportion and degree of occurrence of peripheral neurotoxicity was significantly reduced, the difference was statistically significant. Thus, Jiawei Huangqi Guizhi Wuwu Tang can be effective in preventing peripheral neurotoxicity of oxaliplatin, reduce the side effects of chemotherapy.4.In response to chemotherapy resulted in inhibition of gastrointestinal side, by Ridit analysis, the treatment group and the control group with a significant difference (p<0.05), explained Jiawei Huangqi Guizhi Wuwu Tang reduce gastrointestinal reactions in patients during chemotherapy.5.In the blood system,by Ridit analysis,the treatment group and the control group with significant difference(p<0.05),described Jiawei Huangqi Guizhi Wuwu Tang can reduce bone marrow suppression,suppression decreased peripheral blood cells during chemotherapy.ConclusionsRT-PCR method for detection of colorectal cancer in peripheral blood of patients CK20mRNA, GCCmRNA expression, is a more sensitive method of detecting CTCs, and these two markers and colorectal cancer micro-metastasis. Jiawei Huangqi Guizhi Wuwu Tang combined with chemotherapy in the above two markers on the suppression effect with chemotherapy alone, the difference was not significant. But Jiawei Huangqi Guizhi Wuwu Tang with chemotherapy, the efficacy is better than chemotherapy alone spend. And in reducing oxaliplatin neurotoxicity outer periphery, reducing gastrointestinal toxicity and bone marrow suppression caused by chemotherapy of patients, can play a certain effect. |
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