Increased macrophage inflammation response in pancreatic cancer patients with a diagnosis of Shi-Re
TMR Journals | TMR Modern Herbal Medicine (October 25th, 2021)
Yawen Geng, Shulin Yu, Ling Qian, Kun Chen, Yalei Zhang, Ye Li, Peng Wang
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Objective: Traditional Chinese medicine (TCM) is a comprehensive system of medical practice. ZHENG (also known as syndrome differentiation) is the essence of TCM; however, its molecular basis remains unknown. This study evaluated the molecular basis of Shi-Re ZHENG in patients with pancreatic cancer.
Methods: A total of 144 patients with pathologically-confirmed locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC) were retrospectively recruited between June 2015 and February 2016. Two cohorts, including the discovery cohort (n = 60) and validation cohort (n = 84), were included in this study. QPlex multiplex array and an enzyme-linked immunosorbent assay were used to evaluate serum inflammatory cytokine levels of pancreatic cancer patients with different TCM ZHENG. Receiver operating characteristic (ROC) curve analysis was used to evaluate the importance of the systemic inflammation response index (SIRI) in the detection of Shi-Re ZHENG.
Results: Shi-Re ZHENG patients exhibited a different expression pattern of cytokines, including interleukin (IL)-6, IL-8, chemokine (C-C motif) ligand 18 (CCL18), and C-reactive protein, than patients with other ZHENG diagnoses. M2-like macrophage-related inflammatory cytokines, such as IL-10, CCL17, and CCL22, were increased in Shi-Re ZHENG compared with non-Shi-Re ZHENG patients. The SIRI score was significantly increased in Shi-Re ZHENG compared with non-Shi-Re ZHENG patients (P < 0.001). ROC analysis revealed that SIRI had a diagnostic value for Shi-Re ZHENG both in the discovery cohort (area under the curve [AUC] = 0.833, 95% confidence interval [CI] = 0.709–0.957) and validation cohort (AUC = 0.810, 95% CI = 0.716–0.905). Additionally, pancreatic cancer patients with Shi-Re ZHENG had a significantly shorter survival time than non-Shi-Re ZHENG (P = 0.002).
Conclusion: Shi-Re pancreatic cancer patients are characterized by an increased macrophage inflammation response, which may contribute to a poorer prognosis when compared to those with other ZHENG diagnoses.