不同部位结直肠癌的血清肿瘤指标及中医分型

Serum Tumor Markers and Traditional Chinese Medicine Classification of Colorectal Cancer in Different Parts

目的对不同部位结直肠癌的血清肿瘤指标及中医辨证分型进行比较分析。方法采用回顾性分析,对147例结直肠癌患者,根据原发肿瘤发生部位的不同,分为3组:左半结肠组,右半结肠组和直肠组,对各组的血清肿瘤指标及中医辨证分型进行比较分析。结果血清肿瘤指标CEA、CA125、CA50在各不同解剖部位结直肠癌的表达无明显差异;而CA199的表达差异具有统计学意义(P<0.05),右半结肠癌中CA199阳性率表达最高。湿热蕴结型在直肠癌中多见,与其他部位相比具有统计学意义(P<0.05)。肝肾阴虚型在右半结肠中多见,与其他部位相比具有统计学意义(P<0.05)。而脾虚气滞、瘀毒内阻、脾肾阳虚、气血两虚四个证型均在各组中无显著差异性(P>0.05)。结论在当前结直肠癌提倡个体化、精准化治疗时代,不同部位结肠癌的各种差异为结直肠癌的中西医结合诊疗提供指导,造福患者,使患者能够最大获益。

Objective To compare and analyze the serum tumor markers and TCM syndrome differentiation of colorectal cancer in different parts.Methods This was a retrospective analysis.147 patients with colorectal cancer was divided into 3 groups according to the location of the primary tumor;left colon group,right colon group and rectum group.The serum tumor markers and TCM syndrome differentiation of each group were compared and analyzed.Results There was no significant difference in the expression of serum tumor markers CEA,CA125 and CA50 in different anatomical parts.The expression of CA199 was statistically significant(P<0.05),and the positive expression of CA199 was the highest in right colon cancer.The damp-heat accumulation type was more common in rectal cancer,and it was statistically significant compared with other sites(P<0.05).Deficiency of the liver-yin and kidney-yin type was more common in the right colon,and it was statistically significant compared with other sites(P<0.05).The syndromes of spleen deficiency and qi stagnation,toxic stasis,insufficiency of both the spleen and the kidney,spleen and kidney yang deficiency,and qi-blood deficiency were not significantly different in each group(P>0.05).Conclusion In the current era of colorectal cancer advocated individualized and precise treatment,various differences in colon cancer in different parts provide guidance for the diagnosis and treatment of colorectal cancer with integrated Chinese and Western medicine,benefiting patients and maximizing patients'benefits.