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Colon cancer-related anemia (CCRA) is mainly caused by systemic inflammation, intestinal bleeding, iron deficiency and chemotherapy-induced myelosuppression in colon cancer. However, the best therapeutic schedule and related mechanism on CCRA were still uncertain. Studies on blood enrichment and anti-tumor effects of combined Danggui Buxue Decoction (DBD), Fe and rhEPO based on CCRA and gut microbiota modulation were conducted in this paper. Here, CCRA model was successfully induced by subcutaneous inoculation of CT-26 and i.p. oxaliplatin, rhEPO + DBD high dosage + Fe (EDF) and rhEPO + DBD high dosage (ED) groups had the best blood enrichment effect. Attractively, EDF group also showed antitumor activity. The sequencing results of gut microbiota showed that compared to P group, the relative abundances of Lachnospiraceae and opportunistic pathogen (Odoribacter) in ED and EDF groups were decreased. Interestingly, EDF also decreased the relative abundances of cancer-related bacteria (Helicobacter, Lactococcus, Alloprevotella) and imbalance-inducing bacteria (Escherichia-Shigella and Parabacteroides) and increased the relative abundances of butyrate-producing bacteria (Ruminococcaceae_UCG-014), however, ED showed the opposite effects to EDF, this might be the reason of the smaller tumor volume in EDF group. Our findings proposed the best treatment combination of DBD, rhEPO and Fe in CCRA and provided theoretical basis and literature reference for CCRA-induced intestinal flora disorder and the regulatory mechanism of EDF.
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OBJECTIVE：To systematically evaluate efficacy and safety of Shengxuening tablets in the treatment of cancer-related anemia （CRA），and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from the Cochrane Library ，PubMed，Embase，CJFD，CSJD，Wanfang database and CBM ，RCTs about Shengxuening tablets alone or combined with routine therapy （trial group ）versus routine therapy or blank control （control group ）in the treatment of CRA were collected from inception to July 2019. After literature screening and data extraction ，quality evaluation of included literatures with system evaluation bias risk evaluation tool provided by Cochrane intervention measure system evaluation manual 3.0.2， Meta-analysis of the included literatures was carried out by using Rev Man 5.3 software. RESULTS ：A total of 9 RCTs involving 681 patients were included. Results of Meta-analysis showed that red blood cell count [MD ＝0.62，95％CI（0.30，0.93），P＝0.000 1]， hematocrit level [MD ＝6.12，95％CI（4.97，7.27），P＜0.000 01]，hemoglobin level [MD ＝7.47，95％CI（5.29，9.66），P＜0.000 01]， white blood cell count [MD ＝0.31，95％CI（0.12，0.50），P＝0.001]，platelet count [MD ＝3.06，95％CI（0.84，5.28），P＝0.007]， KPS score [MD ＝5.15，95％CI（2.79，7.51），P＜0.000 1]，quality of life score [MD ＝28.27，95％CI（19.27，37.28），P＜0.000 01] after treatment in trial group were significantly higher than control group ，while the incidence of ADR [RR ＝0.14，95％CI（0.03， 0.76），P＝0.02] in trial group was significantly lower than control group. CONCLUSIONS ：Shengxuening tablets have good efficacy and safety in the treatment of CRA.
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Objective@#To explore the occurrence of anemia in patients with ten common malignant tumors and the related risk factors.@*Methods@#A retrospective analysis was performed in 15 612 patients with ten common malignant tumors admitted in Zhejiang Cancer Hospital from January 2016 to September 2016 by single factor analysis.@*Results@#Among the 15 612 cases, there were 7 468 males (47.83%), 8 144 females (52.17%), and anemia occurred in 5 541 cases, accounted for 35.5% of all the cases with malignancy.Ovarian cancer, gastric cancer and esophageal cancer ranked top three in all types with occurrence of 57.9%, 53.1% and 49% respectively.According to the grading, mild to moderate (Grade 1-2) anemia accounted for 91.2% of the total cancer related anemia, while severe (Grade 3-4) consisted only a small proportion of 8.8%.The mean age of malignant tumor patients was (56.1±11.6)years old, and that showed a significantly difference between the anemia group and non-anemia group in patients' ages among lung cancer, colorectal cancer, gastric cancer and nasopharyngeal carcinoma(t=7.162, 2.486, 4.353, 2.926, all P<0.05). Gender analysis showed that male patients were more prone to cancer related anemia in esophageal cancer and lung cancer(χ2=91.034, 9.240, all P<0.05), and less likely in colorectal cancer, liver cancer and thyroid cancer(χ2=7.707, 6.629, 8.700, all P<0.05) (ovarian cancer, cervix cancer and breast cancer were excluded in this section for their none or rare incidence in male).@*Conclusion@#The patients with malignancy have a relative high occurrence of anemia.Caner related anemia is rather mild to moderate than severe, and tumor types, ages and genders were the risk factors of anemia in patients with malignancy.
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Objective To explore the occurrence of anemia in patients with ten common malignant tumors and the related risk factors.Methods A retrospective analysis was performed in 15 612 patients with ten common malignant tumors admitted in Zhejiang Cancer Hospital from January 2016 to September 2016 by single factor analysis.Results Among the 15 612 cases,there were 7 468 males (47.83%),8 144 females (52.17%),and anemia occurred in 5 541 cases,accounted for 35.5% of all the cases with malignancy.Ovarian cancer,gastric cancer and esophageal cancer ranked top three in all types with occurrence of 57.9%,53.1% and 49% respectively. According to the grading,mild to moderate (Grade 1 -2) anemia accounted for 91.2% of the total cancer related anemia,while severe ( Grade 3 -4) consisted only a small proportion of 8.8%.The mean age of malignant tumor patients was (56.1 ± 11.6)years old,and that showed a significantly difference between the anemia group and non-anemia group in patients＇ages among lung cancer,colorectal cancer,gastric cancer and nasopharyngeal carcinoma(t=7.162,2.486,4.353,2.926,all P＜0.05).Gender analysis showed that male patients were more prone to cancer related anemia in esophageal cancer and lung cancer(χ2 =91.034,9.240,all P＜0.05),and less likely in colorectal cancer,liver cancer and thyroid cancer(χ2 =7.707,6.629,8.700,all P＜0.05) ( ovarian cancer,cervix cancer and breast cancer were excluded in this section for their none or rare incidence in male).Conclusion The patients with malignancy have a relative high occurrence of anemia.Caner related anemia is rather mild to moderate than severe, and tumor types,ages and genders were the risk factors of anemia in patients with malignancy.
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Objective To study the expression and significance of Neogenin,Hepcidin and serum ferritin(SF)in patients with cancer-related anemia.Methods To test the serum levels of Neogenin,Hepcidin and SF in 107 cases,including 55 cases with cancer-related anemia and 52 cases of non-anemia with tumor by ABC-ELISA.Results ①The serum levels of Neogenin in patients with cancer-related anemia were 0.77 ± 0.45 ng/ml,which were lower than 0.98 ± 0.60 ng/ml in non-anemia group (t=2.003 8,P 0.05).③In patients with cancer,there were positive correlation be-tween Neogenin and Hb (r=0.212 4,t=2.226 4,P 0.05).④There were positive cor-relation between Hepsidin and SF (r=0.486 6,P <0.01).Conclusion There were lower expression of Neogenin,higher ex-pression of Hepcidin in patients with cancer-related anemia is a complex process.The abnormal expression of Neogenin and Hepcidin which were lead to the loss of use of iron are the key factors attribute to anemia in patients with cancer.