The Intervention Of Yiqihuoxue Decoction For MCM2 Of Advanced TNBC With Qi Deficiency And Blood Stasis Type And Its Influence On Survival

Objective:1.To observe the influences of Yiqihuoxue Decoction on progression-free survival(PFS)and quality of life for treating advanced TNBC with qi deficiency and blood stasis type.2.To observe the influence of Yiqihuoxue Decoction on MCM2 gene expression.3.To explore the relationship between progression-free survival(PFS)and MCM2 gene expression,and to preliminarily evaluate whether MCM2 can serve as a potential therapeutic target for TNBC.Methods:There were 45 cases enrolled totally,all of whom were Ⅳ phase advanced triple-negative breast cancer patients with qi deficiency and blood stasis type,2-4ml of peripheral blood needed to be extracted respectively when they enrolled and 3 months later,using RT-PCR to detect MCM2 gene expression,and assessing the patients’ symptom scores of traditional Chinese medicine and FACT-B,performing follow-up every 3 months to observe the patients’ biochemical indexes and ECG,etc.The main observation indexes were progression-free survival(PFS),TCM symptom,FACT-B scores and the expression of MCM2 gene.Results:1.The scores of TCM syndrome before and after treatment fitted normal distribution.Applying the paired-sample t test to test the scores before and after treatment,results significant difference between the pre-and post-treatment groups of patients p<0.05 with statistical significance.The results showed that the score means were respectively 15.51 and 13.62,which indicated improvement in Chinese medicine syndrome.In FACT-B Scales,there was significant difference between the pre-and post-treatment groups of patients in physiological status,functional status and emotional well-being(p<0.05),and no significant difference in social/family status and additional attention.Conclusion:Yiqihuoxue Decoction can improve TCM syndrome,physiological status,functional status and emotional well-being of advanced TNBC with qi deficiency and blood stasis type.2.Kaplan-Meier estimates revealed that PFS was correlated with metastatic sites(p<0.05),the expression of MCM2(p<0.05),the expression of Ki-67(p<0.05),pathological grade(p<0.05)and no statistical difference between PFS and age(p>0.05).The expression of MCM2 and Ki-67,metastatic sites and pathological grade were analyzed by Cox proportional hazards regression model.Results show that the expression of MCM2 and Ki-67,pathological grade and metastatic sites were 4 independent risk factors for PFS.Compared with patients with negative expression of MCM2 gene,patients with positive expression of MCM2 gene have high risk of progression of the disease,(RR,3.362,95%confidence interval[CI]1.092-10.352).Compared with Patients with bone metastasis,patients with other metastatic sites have high risk of progression of the disease,(RR,1.629,95%confidence interval[CI]1.121-2.367).Compared with Patients with the expression lower than 50%,patients with the expression higher than 50%have high risk of progression of the disease,(RR,5.353,95%confidence interval[CI]1.779-16.107).Compared with Patients with pathological grade2,patients with the pathological grade3 have high risk of progression of the disease,(RR,4.633,95%confidence interval[CI]1.740-12.338)Conclusion:the expression of MCM2,pathological grade,Ki-67 and metastatic sites were 4 independent risk factors for PFS.MCM2 gene could be a potential target for the treatment.3.The single sample t test was used after conducting internal reference correction of the expression of MCM2 gene.The test value was 0.5,p<0.05,so the gene expression before and after taking Yiqihuoxue Decoction was statistically significantConclusion:Yiqihuoxue Decoction can reduce the expression of MCM2 gene in Pre-RC.