不同中医辨证分型乳腺癌患者血清肿瘤标志物和免疫炎症指标水平差异分析

Analysis of the difference of serum tumor markers and immunoinflammatory indexes in breast cancer patients with different TCM syndrome differentiation types

目的:分析研究不同中医辨证分型乳腺癌患者血清肿瘤标志物和免疫炎症指标水平差异。方法:回顾性选取2020年8月~2023年12月我院收治的126例乳腺癌患者作为研究对象,根据中医辨证分型将患者分为肝郁痰凝型组(n=49)、冲任失调型组(n=43)和正虚毒炽型组(n=34)。比较不同中医辨证分型乳腺癌患者血清肿瘤标志物[糖类抗原125(CA125)、糖类抗原153(CA153)、癌胚抗原(CEA)]和免疫炎症指标[中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)、全身炎症反应指数(SIRI)、系统免疫炎症指数(SII)]水平差异;比较不同中医辨证分型乳腺癌患者的TNM分期与病理分级。结果:正虚毒炽型组乳腺癌患者的CA125、CA153、CEA、NLR、PLR、SIRI、SII水平均高于冲任失调型组和肝郁痰凝型组,冲任失调型组高于肝郁痰凝型组(P<0.05);正虚毒炽型组乳腺癌患者的LMR水平均低于冲任失调型组和肝郁痰凝型组,冲任失调型组低于肝郁痰凝型组(P<0.05);肝郁痰凝型组与冲任失调型组TNM分期以Ⅰ~Ⅱ期为主,正虚毒炽型组TNM分期以Ⅲ~Ⅳ期为主(P<0.05)。结论:不同中医辨证分型乳腺癌患者血清肿瘤标志物和免疫炎症指标存在差异性,检测其表达水平有助于指导乳腺癌中医辨证分型和治疗。

Objective:To analyze and study the differences of serum tumor markers and immune inflammatory indicators in breast cancer patients with different TCM syndrome differentiation.Methods:126cases of breast cancer admitted to our hospital from August 2020 to December 2023 were retrospectively selected as the research objects.According to TCM syndrome differentiation,the patients were divided into three groups:liver depression and phlegm coagulation group(n=49),chong ren disorder group(n=43)and positive deficiency and toxin burning group(n=34).To compare serum tumor markers[carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153),carcinoembryonic antigen(CEA)]and immune inflammatory indicators[neutrophil-lymphocyte ratio(NLR),lymphocyte-monocyte ratio(LMR),platelet-lymphocyte ratio(PLR),systemic inflammatory response index(SIRI),and so on in patients with different TCM syndrome differentiation.Results:The levels of CA125,CA153,CEA,NLR,PLR,SIRI,SII in the patients with breast cancer in the syndrome of positive deficiency and toxin burning group were higher than those in the syndrome of chong ren disorder group and the liver depression and phlegm coagulation group(P<0.05).The LMR level of breast cancer patients in the positive deficiency and toxin burning group was lower than that in the group of chong ren disorder and the liver depression and phlegm coagulation group,and that in the group of chong ren disorder was lower than that in the liver depression and phlegm coagulation group(P<0.05).The TNM stages of the liver depression and phlegm coagulation group and the chong ren disorder group are mainlyⅠ~Ⅱ,and the TNM stages of the positive deficiency and toxic burning group are mainlyⅢ~Ⅳ(P<0.05).Conclusion:There are differences in serum tumor markers and immune inflammatory indexes in patients with different TCM syndrome differentiation types of breast cancer,and detecting their expression levels is helpful to guide TCM syndrome differentiation and treatment of breast cancer.