TCM Constitution Characteristics And Their Correlation With Prognosis Of Triple-negative Breast Cancer In Blank Period

Objective:To explore the relationship between TCM constitution characteristics and prognosis of patients with triple negative breast cancer in the empty window period,in order to provide reference for TCM prevention and treatment of recurrence and metastasis of triple negative breast cancer and improve the survival rate of patients.Methods:Three negative breast cancer patients constitution related influence factors analysis of traditional Chinese medicine using cross-sectional study method,collection in March 2016 to March 2019 Yu Zhongri friendship hospital combine traditional Chinese and western medicine and oncology outpatient visits for the first time three Yin breast cancer patients clinical data,and according to the doctor of traditional Chinese medicine constitution classification and decision table for traditional Chinese medicine physique survey,Outpatient follow-up or telephone and network follow-up were performed to obtain information such as time and location of recurrence and metastasis,and statistical analysis was conducted.Results:(1)Through a cross-sectional survey in this study,it was found that the patients with biased constitution accounted for 86.44%,of which Yang deficiency constitution was the most common constitution in patients with triple negative breast cancer.The order of all biased constitutions from large to small was:Yang deficiency(25.40%),Qi stagnation(15.40%),Qi deficiency(13.33%),blood stasis(11.38%),phlegm-dampness(8.16%),Yin deficiency(6.55%),damp-heat(4.25%),and intrinsic quality(1.95%);(2)Logistic multivariate regression analysis showed that lymph node metastasis(P=0.043)and breast-convalescence(P=0.046)were independent protective factors,with risk ratios of 0.605 and 0.595,respectively.BMI was an independent protective factor for yang-deficiency(P=0.000,OR=0.319),and tumor size was an independent risk factor for yang-deficiency(P=0.047,OR=1.405).Age was an independent risk factor for Yin deficiency(P=0.046,OR=1.859),and Ki-67 was an independent protective factor for Yin deficiency(P=0.012,OR=0.498).In the grouping of vacuity and solidness,BMI was an independent protective factor for vacuity constitution(P=0.000,OR=0.330),an independent risk factor for vacuity constitution(P=0.000,OR=3.383),and age was a protective factor for solidness constitution(P=0.007,OR=0.667).(3)A total of 870 TNBC patients were followed up in this study,the shortest disease-free survival was 12 months,the longest was 39 months,the average disease-free survival was 35.10±5.225 months,and 128 patients had recurrence and metastasis,with a recurrence and metastasis rate of 14.71%.Among them,lung metastasis(35.94%),lymph node metastasis(14.06%),brain metastasis(12.50%),liver metastasis(10.16%)and bone metastasis(9.38%)were detected.There was a significant difference in the distribution of deficiency constitution and non-deficiency constitution in patients with recurrence and metastasis,that is,deficiency constitution was more common in patients with recurrence and metastasis(P<0.05).(4)Logistic multivariate regression analysis related to prognosis showed that deficiency constitution was an independent risk factor for recurrence and metastasis(P=0.049,OR=1.465),and there was a tendency of Yin deficiency substance(P<0.1,OR=1.749),but no significant difference was found.(5)Yang deficiency was the most common among the 128 TNBC patients with recurrence and metastasis,and multivariate logistic regression analysis showed that Yin deficiency was an independent risk factor for liver metastasis(P=0.009,OR=7.451).No significant correlation was found between solid body mass and BMs,but BMI was still an independent risk factor for BMs(P=0.048,OR=3.415).(6)In retrospective cohort studies,lung metastasis was the most common disease in the asthenic constitution cohort,followed by liver metastasis and lymph node metastasis.The 3-year disease-free survival rate in the asthenia constitutions cohort was significantly lower than that in the non-asthenia constitutions cohort(82.69%vs 87.46%),and the difference was statistically significant(P<0.05).(7)The rates of visceral metastasis in the two cohorts with asthenic and non-asthenic constitutions were 10.75%and 8.06%,respectively.Before the propensity score matching,the difference of liver metastasis in the two cohorts was statistically significant(P<0.05).After the matching,the difference of liver metastasis between the two cohorts was not statistically significant,but there was still a trend of difference.(8)Cox multivariate survival analysis showed that lymph node metastasis was an independent prognostic factor for DFS in TNBC patients(P=0.036,HR=1.955).The 3-year disease-free survival rate in the lymph node negative group was higher than that in the lymph node positive group(64.78%vs 17.91%,P<0.01).Conclusion:The constitution of traditional Chinese medicine can be used as a predictor of the prognosis of triple-negative breast cancer,which has important clinical value.It is recommended that patients with triple-negative breast cancer routinely undergo a survey of the constitution of traditional Chinese medicine,so as to provide a basis for the body differentiation treatment and prevention of the recurrence and metastasis of triple-negative breast cancer.