Investigate The Correlation Between Traditional Chinese Medicine Constitution And The Metastasis Of Papillary Thyroid Carcinoma Based On "Discrimination Of Constitution,Disease And Gene "

Objective:This project investigated the traditional Chinese medicine（TCM）constitution type and the clinicopathological characteristics related to PTC metastasis in patients with papillary thyroid carcinoma（PTC）,and studied the correlation between different constitution types and PTC lymph node metastasis and metastasis risk factors.From the perspective of"constitution-disease-gene"and on the basis of the combination of"identification of constitution,disease,and gene",explore new ideas for the prevention and treatment of PTC lymph node metastasis,and provide relevant references for individualized diagnosis and treatment of PTC in TCM.Methods:From July 2021 to December 2022,365 patients with PTC who met the inclusion criteria in the Department of Thyroid and Breast Surgery of the960th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army were selected as the research objects.The TCM constitution information of the patients is collected by questionnaire survey.The general data and postoperative pathological information of the patients were collected.An Excel database was established,and SPSS 27.0statistical software was used for data analysis to explore the correlation between TCM constitution and PTC lymph node metastasis and its risk factors.Results:1.A total of 365 valid questionnaires were obtained in this study.The TCM constitution types of 365 PTC patients were mainly biased constitutions.Among the biased constitutions,the constitution types of PTC patients were mainly divided into three types:yang-deficiency constitution（21.9%）,qi-stagnation constitution（14.2%）,and damp-heat constitution（12.1%）.2.Yang-deficiency constitution was the protective constitution for central lymph node metastasis（CLNM）of PTC（P=0.028）.Damp-heat constitution was a risk constitution for lateral lymph node metastasis（LLNM）（P=0.007）,and the risk of LLNM was 2.707 times of non-damp-heat constitution.3.The clinicopathological features of PTC lymph node metastasis were analyzed,and it was found that age（P=0.039）,tumor size（P<0.001）,bilateral multifocal lesions（P=0.045）,and capsule invasion（P=0.026）were were independent risk factors for CLNM in PTC.Tumor size（P<0.001）,bilateral multifocal lesions（P=0.018）,and combined with Hashimoto’s thyroiditis（P=0.043）were independent risk factors for PTC with LLNM.4.Statistical analysis of TCM constitution types and clinicopatho-logical characteristics of PTC patients found that there were significant differences in the TCM constitution distribution of PTC constitution among different genders（P<0.001）and BMI（P=0.004）.The TCM constitution types of female patients were mainly Yang-deficiency constitution（P=0.003）and Qi-stagnation constitution（P=0.030）,while male patients were mainly composed of phlegm-dampness constitution（P=0.002）and damp-heat constitution（P=0.007）.Phlegm-damp constitution（P=0.036）and damp-heat constitution（P=0.048）were the main types of TCM constitution in overweight patients,and less in patients with Yang-deficiency constitution（P=0.001）;in obese patients,phlegm-dampness constitution（P=0.049）Mainly,patients with yang deficiency（P=0.030）were less.The distribution of TCM constitution was balanced in other clinicopathological information such as age,tumor size,bilaterality,multifocality,number and location of tumors,capsule invasion,and Hashimoto’s thyroiditis,and there was no statistical difference（P>0.05）.5.There was no significant difference between BRAF^V600E gene mutation status and PTC lymph node metastasis and related clinicopathological features（P>0.05）.Conclusion:The type of TCM constitution of PTC patients is correlated with the occurrence of cervical lymph node metastasis.Yang-deficiency constitution is a protective constitution for metastasis,and damp-heat constitution is a dangerous constitution.The TCM constitution type of PTC patients is significantly correlated with metastasis risk factors.To investigate the TCM constitution of patients with PTC,from the perspective of"constitution-disease-gene"and on the basis of the combination of"identification of constitution,disease,and gene",and give full play to the characteristics of TCM constitution as"body disease correlation"and"adjustable constitution",can provide evidence for the recognition of TCM constitution to prevent and treat PTC metastasis.