结直肠癌患者腹腔镜根治术前后肠道菌群的变化研究  

Perioperative changes in intestinal flora of patients underwent laparoscopic colorectal cancer surgery

作　　者：苏超云[1] 施奕君 魏庆忠[1] Su Chao Yun;Shi Yijun;Wei Qingzhong(Department of General surgery,Beijing General Aerospace Hospital,Beijing 100076,China;Tumor center,the Affiliated Beijing Tongren Hospital,Capital Medical University,Beijing 100071,China)

机构地区：[1]北京航天总医院普外科,100076 [2]首都医科大学附属北京同仁医院肿瘤中心,100071

出　　处：《中华普外科手术学杂志（电子版）》2018年第6期481-484,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金资助项目(81703058)~~

摘　　要：目的研究结直肠癌患者腹腔镜根治术前后肠道菌群的变化。方法选择2016年6月到2017年12月收治的结直肠癌患者46例作为结直肠癌组,选择同期健康体检者46例为健康体检组。纳入患者均行腹腔镜根治术,在术前、术后分别采集一次新鲜粪便,测定采集粪便中肠道菌群DNA情况,采用聚合酶链式反应-变性梯度凝胶电泳测定患者手术前、后肠道菌群情况,根据测定结果绘制相应的图谱,分析手术前、后肠道菌群的变化情况。采用SPSS18. 0软件处理,肠道菌群的多样性及丰富度采用(x珋±s)表示,采用配对t检验或F检验,P <0. 05差异有统计学意义。结果对粪便进行PCR扩增,获得的肠道菌群各带均处于200 b P左右,与预期的DNA片段长度相吻合;健康体检者粪便标本多样性指数(H)为(5. 6±0. 2),丰富度(E)为(77. 1±0. 4)条;结直肠癌患者术前粪便标本多样性指数(H)为(3. 8±0. 1)、术后为(4. 1±0. 1),术前丰富度(E)为(45. 3±0. 9)条、术后为(50. 6±0. 6)条,术后肠道菌群多样性及丰富度比术前增加(P <0. 05),但仍低于健康体检组(P <0. 05)。肠道菌群的多样性及丰富度与患者的年龄、临床分期有关(P <0. 05),与性别、病程、肿瘤类型无关(P> 0. 05)。结论正常人肠道菌群的多样性及丰富度较结直肠癌患者高,其与患者的年龄、临床分期有关。临床通过肠道菌群变化分析有助于指导临床治疗。Objective To investigate perioperative changes in intestinal flora of patients underwent laparoscopic colorectal cancer surgery. Methods From June 2016 to December 2017, 46 patients with colorectal cancers were divided into colorectal cancer group, and 46 healthy persons were divided into health examination group. All of 46 patients with colorectal cancers underwent laparoscopic radical surgery. Before and after operation, fresh feces were collected and the DNA of intestinal flora was measured. The intestinal flora was determined by polymerase chain reaction-denaturing gradient gel electrophoresis. Drawing the corresponding map based on the results of the determination. The perioperative changes in intestinal flora were analyzed by using SPSS18.0 software. The diversity and richness of intestinal flora were expressed as （ ±s） , and were examined by using paired t test or F test. A P value〈0.05 was considered as statistically significant difference. Results PCR amplification of feces showed that the bands of intestinal microflora were about 200 BP, which coincided with the expected length of DNA fragment. The fecal diversity index was （5.6±0.2） and the richness （E） was （77.1±0.4） in healthy people. Preoperative fecal specimen diversity index （H） was （3.8±0.1）, and （4.1±0.1） after operation in colorectal cancer patients. The preoperative abundance （E） was （45.3±0.9）, and （50.6＋0.6） after operation. The diversity and richness of intestinal microflora after operation were higher than those before operation （ P 〈0.05）, howeverit was still lower than those in the healthy group （ P 〈0.05）. The diversity and richness of intestinal flora ere related to the age and clinical stage of patients （ P 〈0.05）, however not related to sex, course of disease and tumor type （ P 〉0.05）. Conclusion The diversity and richness of intestinal flora in normal people are higher than those in patients with colorectal cancer, which is related to the age and clinic

关 键 词：结直肠肿瘤 腹腔镜检查 肠杆菌科 变性梯度凝胶电泳 

分 类 号：R735.34[医药卫生—肿瘤]