肠道菌群失调与原发性肝癌的关系研究  

Relationship between intestinal dysbacteriosis and primary liver cancer

作　　者：梁素妨 许琳[1] 张东生[2] 黄维清[3] 

机构地区：[1]青岛大学附属青岛市市立医院消化内科,山东青岛266000 [2]青岛大学附属青岛市市立医院肝胆外科,山东青岛266000 [3]青岛大学附属青岛市市立医院病理科,山东青岛266000

出　　处：《中国肝脏病杂志（电子版）》2015年第4期50-53,共4页Chinese Journal of Liver Diseases：Electronic Version

基　　金：青岛市公共领域科技支撑计划项目;青岛市医疗卫生优秀人才培养项目(13-1-3-14-nsh)

摘　　要：目的探讨原发性肝癌患者中小肠细菌过度生长（small intestinal bacterial overgrowth,SIBO）情况及肠道菌群和Toll样受体4（TLR4）在原发性肝癌发生、发展中的作用。方法选取青岛大学医学院附属青岛市市立医院2013年7月至2015年7月原发性肝癌患者51例,其中男性38例,女性13例,年龄36~73岁,平均（55.71±8.99）岁,选取同期20例健康体检者为对照,行葡萄糖氢呼气试验（GHBT）检查小肠细菌过度生长情况,并用免疫组织化学的方法检查肝癌患者和健康体检者肝脏组织中TLR4的表达情况。结果 51例肝癌患者中GHBT阳性37例（72.6%）,GHBT阴性14例（27.4%）;对照组中无GHBT阳性者,肝癌患者与对照组SIBO发生率差异有统计学意义（χ^2=30.3,P=0.000）。Toll样受体4（Toll-like receptor 4,TLR4）在肝癌组织中均有不同程度的表达,而在正常肝组织中仅有少量表达,差异有显著统计学意义,且肝癌患者中GHBT阳性者肝癌组织TLR4的表达水平高于GHBT阴性者（χ^2=5.088,P=0.024）。结论原发性肝癌患者容易发生SIBO,且肠道菌群可能通过TLR4的表达促进肝癌的发生。Objective To discuss the condition of small intestinal bacterial overgrowth（SIBO） in patients with primary liver cancer and the roles of intestinal flora and toll-like receptor 4（TLR4） in the occurrence and development of primary liver cancer. Methods Total of 51 patients with primary liver cancer in Qingdao Municipal Hospital Affiliated to Qingdao University from July 2013 to July 2015 and 20 healthy controls were selected. Among the 51 patients with primary liver cancer, 38 cases were male and 13 cases were female, the average age was（55.71 ± 8.99） years old. The glucose hydrogen breath test（GHBT） was used to detect the condition of SIBO and the immunohistochemical method was used to detect the expression of TLR4 in liver tissue of all subjects. Results Of 51 patients with patients with primary liver cancer, 37（72.6%） were GHBT positive and 14（27.4%） were GHBT negative, while in the control group, none was GHBT positive. The difference in the incidence of SIBO between liver cancer patients and control group was statistically significant（χ^2 = 30.3, P = 0.000）. The expressions of TLR4 were different in all liver cancer tissues, and in normal liver tissue it had only a small amount of expression. In patients with liver cancer, the expression level of TLR4 in GHBT positive patients was higher than that of GHBT negative（χ^2 = 5.088, P = 0.024）. Conclusion Patients with primary liver cancer are prone to SIBO, and the intestinal flora may promote the occurrence of liver cancer through the expression of TLR4.

关 键 词：原发性肝癌 SIBO TOLL样受体4 GHBT 免疫组化 

分 类 号：R735.7[医药卫生—肿瘤]