Clinical distribution and molecular profiling on postoperative colorectal cancer patients with different traditional Chinese medicine syndromes

摘要

Traditionality TCM syndrome is a kind of pathological profiles that reflect signs and symptoms at a certain stage of a disease, which is the most essential guidelines for the prescription of Chinese herbal formulae and also an important classification for CRC TCM therapy. A clear understanding biological basis of TCM syndrome will help the clinical diagnosis and the treatment for CRC patients hopefully. Abstract Background: Traditional Chinese medicine (TCM) syndrome, also named syndrome, are comprehensive and integral analyses of clinical information which helps to guide different individualized treatment prescriptions. Methods: Thirty healthy controls and 80 colorectal cancer (CRC) patients (including 33 Spleen Qi Deficiency syndrome, 23 Dampness Heat syndrome, 17 Blood Stasis syndrome and 7 other syndrome) were enrolled into this study. Human mRNAs were extracted from peripheral blood mononuclear cells. The gene expression for CRC patients with different TCM syndrome was determined by microarray and qRT-PCR. Results: Spleen Qi Deficiency, Dampness Heat and Blood Stasis were the most common syndromes in CRC patients. There is a significant difference was found in mRNA expression levels (especially for PIK3CA, STAT3, SOX9 and KDM5C ) among Spleen Qi Deficiency, Dampness Heat and Blood Stasis syndrome groups. The higher mRNA levels of JNK1, TP53, MLH1, MSH6, PMS2, SOCS3, TCF7L2, FAM123B, PSAP, FBXW7, SALL4 and the lower expression of inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types. The higher mRNA levels of KRAS, MUC16, EGFR, GRASP65, PIK3CA, MAPK7, CD24, STAT3, SLC11A1, Bcl-2, TXNDC17 and some inflammatory cytokines ( IL-6, IL-23, TNF-a, CXCR4 ) were found in Dampness Heat group but not other syndrome types. Blood Stasis syndrome showed higher expression of SOX9, MLH1, MSH6, KDM5C, PCDH11X, PSAP and SALL4 , and lower mRNA levels of PIK3CA, CD24, STAT3, CXCR4, TXNDC17 and TP53 . The CRC patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types. Conclusion: The identification of syndrome conditions had different impacts on CRC prognosis, and which might be related with different mRNA expression levels. Some oncogenes and pro-inflammatory cytokines were highly expressed in Dampness Heat group but not other syndrome types, suggesting that the CRC patients with Dampness Heat syndrome might have a poor prognosis. Our results prelimitarily uncovered the molecular basis of syndrome differences in CRC prognosis, a better understanding for TCM treatment of CRC.