1. A Four Ingredients Chinese Herbal Formula, Decreases the Metastatic Recurrence of Postoperative Patients With Stage II- III Colorectal Cancer
- Author
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Xing Wu, Xiyu Wang, Qi Shi, Minguang Zhang, Qiqi Le, and Fenggang Hou
- Subjects
medicine.medical_specialty ,Colorectal cancer ,business.industry ,Internal medicine ,medicine ,Stage ii ,medicine.disease ,business ,Gastroenterology - Abstract
OBJECTIVETo identify the effect of traditional Chinese medicine (TCM) on postoperative patients with stage II-III colorectal cancer (CRC) and to explore the core herb combination and its mechanism.METHODSFor this observational cohort study, patients diagnosed between January 2006 and September 2016 were enrolled from two hospitals, data was followed up from January 2019 to November 2020 and was analyzed in December 2020. The primary outcome, disease-free survival (DFS), was compared for those patients who received or did not receive TCM, and the secondary outcome was the hazard ratio (HR). The relevance principle was used to obtain the candidate herb combinations, and the core combination was evaluated through assessment of efficacy and representativeness. Then, the interactions among herbs and CRC were visualized by Cytoscape. Furthermore, related biological processes and signalling pathways were obtained by enrichment and KEGG analyses.RESULTSA total of 707 patients were finally included. In general, TCM decreased the metastatic recurrence associated with stage II-III CRC (HR: 0.61, log-rank P<0.05). Among those patients in the TCM group, the core combination was Baizhu → Yinchen, Chenpi, and Fuling (C), and its antitumor mechanism was most likely related to 30 core targets, which were associated with 327 biological processes and 111 KEGG pathways. The most closely associated pathways were the PI3K-Akt, MAPK and HIF-1 pathways.CONCLUSIONSOn the whole, a combination of four herbs, Baizhu → Yinchen, Chenpi, and Fuling, could reduce metastatic recurrence in postoperative patients with stage II-III CRC, and the mechanism might be related to the PI3K-Akt, MAPK and HIF-1 pathways.
- Published
- 2021