合并阻塞型睡眠呼吸暂停低通气综合征的结直肠癌患者的肠道菌群状况及其慢性间歇性缺氧状况与病理特征的关系  

Intestinal flora condition and relationship of chronic intermittent hypoxia condition with pathological characteristics in colorectal cancer patients with concomitant obstructive sleep apnea-hypopnea syndrome

作　　者：何斌[1] 薛珉[1] 余苏云[1] 贝颂华 高习文[1] HE Bin;XUE Ming;YU Su-yun;BEI Song-hua;GAO Xi-wen(Department of Respiratory Medicine,Minhang District Central Hospital,Fudan University,Shanghai 201199,China;Endoscopy Center,Minhang District Central Hospital,Fudan University,Shanghai 201199,China)

机构地区：[1]复旦大学附属闵行区中心医院呼吸内科,上海市201199 [2]复旦大学附属闵行区中心医院内镜中心,上海市201199

出　　处：《广西医学》2021年第3期280-284,301,共6页Guangxi Medical Journal

基　　金：上海市闵行区卫生计生委课题(2019MHZ016)。

摘　　要：目的分析合并阻塞型睡眠呼吸暂停低通气综合征(OSAHS)的结直肠癌患者肠道菌群状况和病理特征。方法选择100例患者或体检者作为研究对象,其中健康者(对照组)、结直肠癌合并OSAHS患者(结直肠癌+OSAHS组)、单纯结直肠癌患者(结直肠癌组)、单纯OSAHS患者(OSAHS组)各25例。采集所有研究对象的粪便标本,检测并对比各组肠道菌群集落数。检测结直肠癌患者癌组织以及非结肠癌者肠黏膜组织的缺氧诱导因子1(HIF-1)、谷氨酰胺酶2(GLS2)的表达情况。比较4组HIF-1和GLS2的阳性率,以及结肠癌患者癌组织、癌旁组织HIF-1、GLS2表达阳性率的差异。分析结直肠癌+OSAHS患者临床病理特征与HIF-1、GLS2表达水平的关系。结果结直肠癌+OSAHS组、结直肠癌组、OSAHS组、对照组的乳酸杆菌集落数依次升高,大肠埃希菌集落数依次降低;结直肠癌+OSAHS组、结直肠癌组的脆弱拟杆菌、粪肠球菌集落数均高于OSAHS组、对照组,双歧杆菌集落数均低于OSAHS组、对照组(均P<0.05)。与对照组比较,结直肠癌+OSAHS组、结直肠癌组、OSAHS组的HIF-1、GLS2表达阳性率均升高(均P<0.05)。结直肠癌患者癌组织HIF-1、GLS2表达阳性率高于癌旁组织(均P<0.05)。结直肠癌+OSAHS患者中,浸润深度大、Dukes分期高、合并淋巴结转移的患者的GLS2阳性率升高,合并淋巴结转移的患者的HIF-1阳性率升高(均P<0.05)。结论合并OSAHS的结直肠癌患者存在明显的肠道菌群紊乱,OSAHS可能通过影响肠道菌群引起结直肠癌,并与其病理特征密切相关。Objective To analyze intestinal flora condition and pathological characteristics in colorectal cancer patients with concomitant obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 100 patients or physical examinees were enrolled as subjects,including 25 healthy individuals(control group),25 colorectal cancer patients complicated with OSAHS(colorectal cancer+OSAHS group),25 patients with simple colorectal cancer(colorectal cancer group)and 25 patients with simple OSAHS(OSAHS group).The fecal specimens were collected from all subjects for detecting and comparing intestinal flora colony count in all groups.The expression of hypoxia inducible factor 1(HIF-1)and glutaminase 2(GLS2)was detected in colorectal cancer tissue of colorectal cancer patients and intestinal mucosal tissue of individuals without colorectal cancer.The positive rates of HIF-1 and GLS2 were compared among the four groups,and the positive rates of cancer tissue HIF-1 and GLS2 expression were compared with the rates of paracancerous tissue HIF-1 and GLS2 expression in patients with colon cancer.The relationship of clinicopathological characteristics with HIF-1 or GLS2 expression level was analyzed in the colorectal cancer+OSAHS group.Results Lactobacillus colony count increased and Escherichia coli colony count decreased in the order of the colorectal cancer+OSAHS group,the colorectal cancer group,the OSAHS group and the control group;the colorectal cancer+OSAHS group and the colorectal cancer group had higher colony counts of Bacteroides fragilis and Enterococcus faecalis and lower Bifidobacterium colony count in comparison with the OSAHS group or the control group(all P<0.05).Compared with the control group,the colorectal cancer+OSAHS group,the colorectal cancer group and the OSAHS group exhibited increased positive rates of HIF-1 and GLS2 expression(all P<0.05).In patients with colorectal cancer,the positive rates of HIF-1 and GLS2 expression in cancer tissue were higher than those in paracancerous tissue(all P<0.05).Among patient

关 键 词：阻塞型睡眠呼吸暂停低通气综合征 结直肠癌 慢性间歇性缺氧 肠道菌群 缺氧诱导因子1 谷氨酰胺酶 病理特征 

分 类 号：R735.3[医药卫生—肿瘤] R766[医药卫生—临床医学]