结直肠癌气滞血瘀证与湿热下注证患者预后相关因素的比较研究

Comparative investigation on the prognosis of colorectal cancer patients between the qi stagnation and blood stasis syndrome and the damp heat injection syndrome

目的:比较研究气滞血瘀证和湿热下注证结直肠癌患者预后相关因素。方法:收集行开腹结直肠癌根治术的结直肠癌患者117例,其中气滞血瘀证组80例,湿热下注证组37例。观察两组患者的临床病理学特征,采用免疫组织化学方法观察患者肿瘤组织内错配修复蛋白的表达情况,Sanger测序技术检测患者肿瘤组织内是否存在KRAS、BRAF基因突变。结果:气滞血瘀证组患者中出现特殊类型腺癌、高T分期、高N分期、脉管内癌栓、神经侵犯和错配修复蛋白功能缺失的患者比例均高于湿热下注证组,KRAS、BRAF基因突变率高于湿热下注证组,但差异均无统计学意义。结论:结直肠癌气滞血瘀证患者中存在不良预后因素的比例高于湿热下注证患者。

Objective:To investigate the prognosis of colorectal cancer patients between the qi stagnation and blood stasis syndrome and the damp heat injection syndrome.Methods:A total of 117 patients undergoing open radical resection for CRC were collected at Guang’anmen Hospital from January 2015 to December 2019.There were 80 cases of the qi stagnation and blood stasis syndrome and 37 cases of the damp heat injection syndrome.The clinicopathological features were compared between two syndromes.The expression of mismatch repair proteins(MLH,MSH2,MSH6 and PMS2) were studied by immunohistochemical stains.KRAS and BRAF mutation status were detected using Sanger sequencing.Results:The proportion of special types of adenocarcinomas,high T staging,high N staging,intravascular tumor thrombi and nerve invasion in the qi stagnation and blood stasis syndrome group was higher than that in the damp heat injection syndrome group.The proportion for the patients with mismatch repair protein dysfunction,KRAS and BRAF mutation in the qi stagnation and blood stasis syndrome group was higher than that in the damp heat injection syndrome group,however,the differences was not statistically significant.Conclusion:The proportion of patients with adverse prognostic factors in the qi stagnation and blood stasis syndrome group was higher than that in the damp heat injection syndrome group.