结肠癌患者粪便胆汁酸和短链脂肪酸的变化及其意义  

Changes of fecal short-chain fatty acid and bile acid levels in patients with colon cancer

作　　者：杨德生[1] 康玉华[1] 李福春[1] 胡军红[1] 陈宏超[2] 索智敏[1] 

机构地区：[1]河南大学淮河医院消化内科,开封475000 [2]郑州市第一人民医院消化内科,450000

出　　处：《中华临床营养杂志》2013年第4期204-208,共5页Chinese Journal of Clinical Nutrition

基　　金：河南大学自然科学基础研究项目（06YBZR061）

摘　　要：目的 探讨结肠癌患者粪便胆汁酸和短链脂肪酸水平的变化及意义。方法 收集189例结肠癌、201例腺瘤性息肉患者和512例经肠镜检查结果正常者的粪便标本，采用酶联免疫吸附法检测3组研究对象粪便胆汁酸及短链脂肪酸的浓度。结果 总胆汁酸、初级胆汁酸和次级胆汁酸在正常对照组、腺瘤性息肉组、结肠癌组差异均无统计学意义（P均＞0.05）。结肠癌组的鹅脱氧胆酸［0.338（0.101,0.416） mg/g］高于腺瘤性息肉组［0.241（0.108,0.375） mg/g］和正常对照组［0.248（0.110,0.371） mg/g］（P＝0.025，P＝0.023），而腺瘤性息肉组和正常对照组差异无统计学意义（P＞0.05）。结肠癌组和腺瘤性息肉组的脱氧胆酸［0.375（0.136,0.503） mg/g与0.369（0.113,0.494）mg/g］高于正常对照组［0.277（0.115,0.412）mg/g］（P＝0.026，P＝0.024），而结肠癌组和腺瘤性息肉组差异无统计学意义（P＞0.05）。结肠癌组的石胆酸［0.386（0.147,0.507）mg/g］高于腺瘤性息肉组［0.103（0.012,0.238）mg/g］和正常对照组［0.239（0.081,0.405）mg/g］（P＝0.011，P＝0.027），而腺瘤性息肉组低于正常对照组（P＝0.022）。总的短链脂肪酸、乙酸、丙酸和异戊酸在正常对照组、腺瘤性息肉组、结肠癌组差异均无统计学意义（P均＞0.05）。结肠癌组和腺瘤性息肉组的丁酸［0.105（0.059,0.198）mg/g与0.090（0.050,0.183）mg/g］、异丁酸［0.036（0.024,0.046）mg/g与0.025（0.020,0.034）mg/g］高于正常对照组［0.081（0.051,0.107）mg/g与0.021（0.016,0.029）mg/g］（丁酸：P＝0.026，P＝0.021；异丁酸：P＝0.025，P＝0.029），且结肠癌组高于腺瘤性息肉组，差异均有统计学意义（丁酸：P＝0.031；异丁酸：P＝0.024））。结论 粪便中鹅脱氧胆酸、石胆酸和丁酸、异丁酸可能与结肠癌的发生有关，同时脱氧胆酸可能与结肠癌和结肠腺瘤均存在联系，而胆汁酸和Objective To investigate the changes of fecal short-chain fatty acids （SCFA） and bile acid levels in patients with colon cancer.Methods Totally 189 patients with colon cancer （CC group）, 201 patients with adenomatous polyp （AP group）, and 512 healthy patients （control group） who were confirmed by endoscopy were included in this study. The fecal SCFA and bile acid levels were measured by enzyme linked immunosorbent assay. Results The total bile acids, primary bile acids, and secondary bile acids were not significantly different among these three groups （P〉0.05）. The chenodeoxycholate level in the CC group [0.338 （0.101,0.416）mg/g] was significantly higher than that in AP group [0.241 （0.108,0.375）mg/g] and control group [0.248（0.110,0.371）mg/g]（P=0.025,P=0.023）, but was not significantly different between the AP group and the control group （P〉0.05）. The deoxycholic acid level in CC group [0.375 （0.136,0.503）mg/g] and AP group [0.369 （0.113,0.494）mg/g] were significantly higher than that in control group [0.277 （0.115,0.412）mg/g]（P=0.026,P=0.024）, and the difference between CC group and AP group was not statistically significant （P〉0.05）. The level of lithocholic acid in CC group [0.386 （0.147,0.507）mg/g] was significantly higher than those in the AP group [0.103 （0.012,0.238）mg/g] and control group [0.239 （0.081,0.405）mg/g] （P=0.011,P=0.027）; also, its level in AP group was significantly lower than that in the control group （P=0.022）. The levels of total short-chain fatty acids, acetic acid, propionic acid, and isovaleric acid were not significantly different among the control group, AP group, and CC group（P〉0.05）. The levels of butyrate [0.105 （0.059,0.198）mg/g, 0.090（0.050,0.183）mg/g], isobutyl acid [0.036 （0.024,0.046）mg/g,0.025（0.020,0.034）mg/g] in CC group and AP group were significantly higher than in the control group [0.081 （0.051,0.107）mg/g, 0.021（0.016,0.029）mg/g] （butyrate：P=0.026,P=00

关 键 词：结肠癌 腺瘤性息肉 粪便胆汁酸 粪便短链脂肪酸 

分 类 号：R735.3[医药卫生—肿瘤]