Comparative analysis of immune function, hemorheological alterations and prognosis in colorectal cancer patients with different traditional Chinese medicine syndromes
Comparative analysis of immune function, hemorheological alterations and prognosis in colorectal cancer patients with different traditional Chinese medicine syndromes
复制标题
不同中医证候结直肠癌患者免疫功能、血液流变学改变及预后的比较分析
DOI：
10.3233/cbm-170805
复制
发表时间：
2018-01-01
影响因子：
3.1
通讯作者：
Li, Ze-Geng
中科院分区：
文献类型：
--
作者：
Wang, Cheng-Yang;Ding, Huan-Zhang;Li, Ze-Geng
目的：本研究旨在探讨不同中医证型结直肠癌患者免疫功能、血液流变学改变及预后评估的差异。将患者分为虚证、实证、虚实夹杂证3个证型，并选择53名健康体检者作为对照。采用流式细胞仪检测外周血淋巴细胞亚群（CD 3+、CD 4+、CD 8+、NK细胞水平及CD 4 +/CD 8+、Th 1/Th 2、Tc 1/Tc 2比值）。采用全自动血液流变仪测定全血粘度（WBV）、血浆粘度（PV）、红细胞压积（Hct）、红细胞沉降率（ESR）、血浆纤维蛋白原浓度（PFC）。采用单因素分析和考克斯回归分析对不同中医证型结直肠癌患者的预后进行评价。与健康人相比，结直肠癌患者的CD 3+、CD 4+、NK细胞、CD 4 +/CD 8+、Th 1/Th 2、Tc 1/Tc 2比值均降低，而CD 8+、WBV、PV、Hct、ESR、PFC均升高。实证组患者的CD 3+、CD 4+、NK细胞水平、CD 4 +/CD 8+、Th 1/Th 2、Tc 1/Tc 2比值最高，而CD 8+水平最低，虚证组则相反。与实证组相比，实证组WBV、PV、Hct、ESR、PFC均降低。除围术期输血量外，病理类型、手术方式、TNM分期、肝转移、中医治疗时间、中医证型是影响结直肠癌患者预后的独立因素。结论：中医虚证患者免疫功能低下，预后差;中医实证患者免疫功能较高，预后好。
OBJECTIVE: The present study investigates the differences in immune function, hemorheological alterations and prognostic evaluation in colorectal cancer (CRC) patients with different traditional Chinese medicine (TCM) syndromes.METHODS: A total of 128 patients, diagnosed as stage II and III of CRC, were recruited. They were assigned into three TCM syndromes: deficiency syndrome, excess syndrome, and syndrome of intermingled deficiency and excess, and another 53 healthy individuals were selected as the control. Flow cytometry was used to determine the peripheral blood lymphocyte subsets (the levels of CD3+, CD4+, CD8+, NK cells, and the ratios of CD4+/CD8+, Th1/Th2 and Tc1/Tc2). Whole blood viscosity (WBV), plasma viscosity (PV), hematocrit (Hct), erythrocyte sedimentation rate (ESR), plasma fibrinogen concentration (PFC) were measured using a fully-automatic blood rheological instrument. The univariate analysis and Cox regression analysis were conducted to evaluate the prognosis of CRC patients with different TCM syndromes.RESULTS: Compared with healthy individuals, CRC patients with three different syndromes had lower levels of CD3+, CD4+, NK cells, and ratios of CD4+/CD8+, Th1/Th2 and Tc1/Tc2, but higher level of CD8+, WBV, PV, Hct, ESR and PFC. Besides, patients with excess syndrome showed the highest levels of CD3+, CD4+ and NK cells, and ratios of CD4+/CD8+, Th1/Th2 and Tc1/Tc2, but the lowest level of CD8+ among three syndromes, and those with deficiency syndrome showed an opposite trend. Compared with patients with excess syndrome, those with deficiency syndrome showed decreased WBV, PV, Hct, ESR and PFC. The pathological type, surgical approach, tumor node metastasis (TNM) stage, liver metastasis, TCM treatment time and different TCM syndromes were independent factors of prognostic survival in CRC patients except perioperative blood transfusion volume.CONCLUSIONS: Taken together, we conclude that patients with TCM deficiency syndrome has lower immune function and poorer prognosis while patients with TCM excess syndrome has higher immune function and better prognosis of CRC.