胃癌患者中医辨证分型与外周血CXCR4、IL-6/STAT3通路的关系探究

Exploration of traditional Chinese medicine in patients with gastric cancer and peripheral blood CXCR4, IL-6/STAT3pathway

目的:探究胃癌患者中医辨证分型与外周血趋化因子受体(CXCR)4、白细胞介素(IL)-6/信号转导转录活化因子(STAT)3通路的关系。方法:纳入2022年5月~2023年5月期间本院收治的124例胃癌患者进行分析,依据临床症状、脉搏等对胃癌患者进行中医辨证,并比较不同证型胃癌患者免疫功能[CD 3^(+)、CD 4^(+)、CD 4^(+)/CD 8^(+)]、外周血CXCR4、IL-6/STAT3通路表达情况以及预后情况。结果:124例胃癌患者临床主要包括5种辨证分型,包括肝气犯胃证33例(26.61%)、脾胃虚寒证24例(19.35%)、胃热伤阴证29例(23.39%)、气滞血瘀证21例(16.94%)、气血亏虚证17例(13.71%);5种辨证分型胃癌患者的外周血CXCR4、IL-6及STAT3 mRNA表达情况比较,气滞血瘀证、气血亏虚证均高于其他3种证型(P<0.05),且气滞血瘀证、气血亏虚证之间比较,差异无统计学意义(P>0.05);5种辨证分型胃癌患者的免疫功能比较,气滞血瘀证、气血亏虚证的CD 3^(+)、CD 4^(+)、CD 4^(+)/CD 8^(+)均低于其他3种证型(P<0.05),且气血亏虚证低于气滞血瘀证(P<0.05);随访1年,气滞血瘀证、气血亏虚证的生存率均低于其他3种证型(P<0.05),且气滞血瘀证、气血亏虚证之间比较,差异无统计学意义(P>0.05)。结论:胃癌患者临床常见中医辨证分型主要包括肝气犯胃证、脾胃虚寒证、胃热伤阴证、气滞血瘀证以及气血亏虚证,且不同辨证分型患者之间的外周血CXCR4水平及IL-6/STAT3通路表达存在差异。

Objective: To explore the relationship between TCM syndrome differentiation and peripheral blood chemokine receptor(CXCR) 4, interleukin(IL)-6/ signal transduction transcription-activating factor(STAT) 3pathways in patients with gastric cancer. Methods: A total of 124patients with gastric cancer admitted to our hospital from May 2022to May 2023were included for analysis, and TCM differentiation of gastric cancer patients was performed according to clinical symptoms and pulse. The immune function [CD3^(+), CD4^(+), CD4^(+)/CD8^(+)], peripheral blood CXCR4, IL-6/STAT3pathway expression and prognosis of patients with different syndrome types of gastric cancer were compared. Results: The 124cases of gastric cancer mainly included 5syndrome differentiation types, including 33cases(26.61%) of liver-Qi-invaded stomach syndrome, 24cases(19.35%) of spleen-stomach deficiency cold syndrome, 29cases(23.39%) of stomach heat injury Yin syndrome, 21cases(16.94%) of qi stagnation and blood stasis syndrome, 17cases(13.71%) of qi blood deficiency syndrome. The expression of CXCR4, IL-6and STAT3mRNA in peripheral blood of gastric cancer patients with 5types of syndrome differentiation showed that Qi-blood-stasis syndrome and Qi-blood-deficiency syndrome were higher than those of the other 3types( P <0.05), and there was no statistical significance between Qi-blood-stasis syndrome and Qi-blood-deficiency syndrome( P >0.05). The immune function of gastric cancer patients with 5types of syndrome differentiation showed that CD3^(+), CD4^(+), CD4^(+)/CD8^(+)of Qi-blood stasis syndrome and Qi-blood deficiency syndrome were lower than those of other 3types( P <0.05), and Qi-blood deficiency syndrome was lower than Qi-blood stasis syndrome( P <0.05). After 1year of follow-up, the survival rate of Qi-blood-stasis syndrome and Qi-blood-deficiency syndrome was lower than that of other 3syndrome types( P <0.05), and there was no statistical significance between Qi-blood-stasis syndrome and Qi-blood-deficiency syndrome( P >0.05). Conclusion: The common TCM syndrome differentiation types in patients with gastric cancer mainly include liver-qi attack on stomach syndrome, spleen-stomach deficiency cold syndrome, stomach heat injury to Yin syndrome, qi stagnation and blood stasis syndrome, and qi and blood deficiency syndrome, and there are differences in peripheral blood CXCR4level and IL-6/STAT3pathway expression among patients with different syndrome differentiation types.