Abstract
Colorectal cancer is one of the leading causes of tumor-associated death, and traditional Chinese medicine (TCM) classifies colorectal cancer into various subtypes mainly according to the symptomatic pattern identification (ZHENG). Here, we investigated the difference in metabolic profiles of serum by comparing colorectal cancer subjects with Nondeficiency (ND), Qi deficiency (QD), and Yin deficiency (YD). The ratio of subjects with carcinoembryonic antigen (CEA) was higher in YD pattern, and the ratio of subjects with carbohydrate antigen 19-9 (CA19-9) was higher both in YD and in QD, compared with ND. As a result of metabolomics analysis, twenty-five metabolites displayed differences between QD and ND, while twenty-eight metabolites displayed differences between YD and ND. The downregulated metabolites in QD/ND and YD/ND mainly include carbohydrates and the upregulated metabolites mainly include amino acids and fatty acids, suggesting conversion obstruction of carbohydrates, fatty acids, and amino acids occurs in patients with QD and YD compared with ND. Our results demonstrate that colorectal cancer patients with QD or YD were associated with metabolic disorders and the variations of serum metabolic profiles may serve as potential biochemical markers for diagnosis and prognosis of colorectal cancer patients displayed QD or YD patterns.
Highlights
Colorectal cancer (CRC) is globally one of the most commonly diagnosed cancers, which is the fourth leading cause of death in cancer patients [1]
Metabolomics profiling was performed by using Gas chromatography–mass spectrometry Principal component analysis (PCA) (GC-MS) to compare the difference of serum metabolic profiles in colorectal cancer subjects with ND, Qi deficiency (QD), and Yin deficiency (YD) and our results demonstrate that colorectal cancer patients with QD or YD were associated with metabolic disorders and the variations of serum metabolic profiles may serve as potential biochemical markers for diagnosis and prognosis of colorectal cancer patients displayed QD or YD patterns
The YD subtype in CRC had a significant association with higher carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA199) expression compared with the ND and QD group (Table 1)
Summary
Colorectal cancer (CRC) is globally one of the most commonly diagnosed cancers, which is the fourth leading cause of death in cancer patients [1]. TCM, which emphasizes bringing the patient’s body, mind, and spirit into harmony, is coming to a promising and alternative approach for the prevention and treatment of tumor patients including CRC. TCM rests squarely on ZHENG (syndrome) differentiation, a process of analyzing data collected through four combined diagnostic methods: WANG (inspection), WEN (falling-rising tone, auscultation, and olfaction), WEN (falling tone, inquiry), and QIE (palpation). All diagnostic and therapeutic methods in TCM are Evidence-Based Complementary and Alternative Medicine based on the differentiation of ZHENG. According to the theory of TCM, patients with a specific disease, including cancer, exhibit various types of syndrome (ZHENG) and categorization of different types of syndrome is a critical concept to recognize the nature of cancer patients. Treatment of cancer based on ZHENG differentiation, known as “Bian Zheng Lun Zhi,” can be used to guide the choice of treatment with TCM herbal formulae. There was a dramatic increase in the total number of publications reporting the concept of TCM ZHENG in the cancer therapy
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