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Abstract
Background Many associations between tongue fur and different physiological and biochemical indexes have been revealed. However, the relationship between tongue fur and tumor markers remains unexplored. Methods We collected the medical examination reports of 1625 participants. Participants were residents of Chengdu, China, undergoing routine health checkups at the health management center of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine between December 2018 and September 2020. The participants' tongue fur thickness was measured using the DAOSH four-diagnostic instrument. Tumor marker levels, including t-PSA, AFP, CEA, CA125, and CA199, were measured in the clinical laboratory. Curve-fitting and multivariable logistic regression were used to analyze the association between tongue fur thickness and tumor marker abnormality. Results Curve-fitting showed that the relationship between tongue fur thickness and abnormal tumor marker rate was nonlinear, similar to a U shape. As the tongue fur thickness value increased, the abnormal tumor marker probability initially decreased and then increased. Logistic regression showed that, in the crude model, compared with the thin tongue fur group, the odds ratios (ORs) and 95% confidence intervals (CIs) of the less or peeling tongue fur group and thick tongue fur group for tumor marker abnormality were 1.79 (1.02–3.17) and 1.70 (1.13–2.54), respectively. After adjusting gender, age, body mass index (BMI), smoking history, drinking history, tongue color, the form of the tongue, and fur color, the ORs and 95% CIs of the less or peeling tongue fur group and thick tongue fur group were 1.93 (1.04–3.57) and 1.82 (1.17–2.81), respectively. Conclusions Excessive or very little tongue fur is associated with tumor marker abnormality. Further cross-sectional studies are needed to evaluate the clinical value of tongue fur for cancer diagnosis and screening.
Highlights
Tongue diagnosis has been widely used in both traditional Chinese medicine (TCM) and ancient Greek medicine [1, 2]
Baseline Characteristics of Participants. e participants’ average age was 48.2 ± 10.4 years old, and about 57.7% were male. e participants were separated into three groups: thin tongue fur, less or peeling tongue fur, and thick tongue fur groups (Figure 2), each having 534, 188, and 903 participants, respectively. e overall rate of tumor marker abnormality in the thin fur group was lower than that in the less or peeling fur group and the thick fur group
The form of the tongue and the fur color were unevenly distributed in the thin fur, less or peeling fur, and thick fur groups. ere was no statistically significant difference in age, gender, body mass index (BMI), smoking history, drinking history, tongue color, and abnormal rates of t-PSA, Alpha-fetoprotein CEA (AFP), CEA, Carbohydrate antigen 125 CA199 (CA125), and CA199 between the different tongue fur thickness groups (Table 1)
Summary
Tongue diagnosis has been widely used in both traditional Chinese medicine (TCM) and ancient Greek medicine [1, 2]. According to TCM theory, stomach qi, a vital life force, nourishes all five viscera and six bowels and helps generate tongue fur. Modern medical research has uncovered the essence of tongue fur. It consists of desquamated epithelial cells, blood cells, metabolites, nutrients, and bacteria [4]. Curve-fitting and multivariable logistic regression were used to analyze the association between tongue fur thickness and tumor marker abnormality. Curve-fitting showed that the relationship between tongue fur thickness and abnormal tumor marker rate was nonlinear, similar to a U shape. As the tongue fur thickness value increased, the abnormal tumor marker probability initially decreased and increased. Excessive or very little tongue fur is associated with tumor marker abnormality. Further cross-sectional studies are needed to evaluate the clinical value of tongue fur for cancer diagnosis and screening
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