肠道微生物预测宫颈癌及子宫内膜癌患者放疗后放射性肠炎的初步研究  

Preliminary study on gut microbiota prediction of radiation enteritis in patients with cervical and endometrial cancers

作　　者：姜海红 李小凡[2] 尤静[2] 古小璇 王建六[1] Jiang Haihong;Li Xiaofan;You Jing;Gu Xiaoxuan;Wang Jianliu(Department of Obstetrics and Gynecology,Peking University People's Hospital,Beijing 100044,China;Department of Radiation Oncology,Peking University Cancer Hospital,Beijing 100142,China)

机构地区：[1]北京大学人民医院妇产科,100044 [2]北京大学肿瘤医院放射肿瘤科,100142

出　　处：《中华放射医学与防护杂志》2021年第8期571-578,共8页Chinese Journal of Radiological Medicine and Protection

基　　金：国家科技支撑计划项目(2015BAI13B06)。

摘　　要：目的探索宫颈癌及子宫内膜癌患者肠道微生物与放疗期间放射性肠炎的严重程度的关系。方法收集37例宫颈癌和子宫内膜癌接受放射治疗的患者粪便样本。包括根治性放疗(RR)和术后放疗(PR)患者。根据CTCAE 5.0中腹泻和直肠炎的级别记录症状,任何症状2级及以上记为高症状级别(HG),否则记为低症状级别(LG)。用16S rRNA测序方法对粪便样本的DNA进行测序及生物统计分析,分析指标包括α多样性、β多样性、线性判别分析效应量(LEfSe)和MetagenomeSeq分析。结果放疗前LG患者的肠道微生物α多样性高于HG患者(P<0.05)。两组的β多样性也存在差异(stress<0.2)。放疗前HG组患者样本中的Ruminococcus gnavus明显高于LG组患者(P<0.05)。这种微生物有可能成为放疗前预测放射性肠炎的标志物种。另外,根治性放疗(RR)患者与术后放疗(PR)患者相比,放疗前肠道微生物群多样性更高,且放疗后放射性肠炎的发生率更低。Faecalibacterium prausnitzii在放疗前根治组中较高(P<0.05),可能与放疗不良反应呈负相关。结论宫颈癌及子宫内膜癌患者的肠道微生物群特征与放疗期间放射性肠炎的严重程度密切相关。手术等治疗可能会改变宫颈癌及子宫内膜癌患者的肠道微生物群状态,降低患者的辐射耐受性,使其更容易发生更为严重的放射性肠炎。Objective To explore the relationships between the gut microbiota in patients with cervical and endometrial cancers and the severity of radiation enteritis they suffered during radiotherapy.Methods Feces samples were collected from 37 patients with cervical or endometrial cancer who received radical radiotherapy(RR)and postoperative radiotherapy(PR).Symptoms were recorded according to the grades of diarrhea and proctitis stated in CTCAE 5.0.The grade of symptoms was considered a high grade(HG)in the case of≥2 and a low grade(LG).The 16S rRNA sequencing technology was used for DNA analysis of the samples.Results Theαdiversity of gut microbiota was significantly higher in patients with LG symptoms(LG group)than that in patients with HG symptoms(HG group,P<0.05)and theβdiversity also differed between the two groups(stress<0.2)before radiotherapy.Meanwhile,the Ruminococcus gnavus was significantly higher in the HG group than that in the LG group before radiotherapy(P<0.05),and thus it may serve as a biomarker for the prediction of the severity of radiation enteritis in the patients before radiotherapy.The gut microbiota in the LG and HG groups showed different changes after three weeks of radiotherapy.In addition,RR patients showed higher gut microbiota diversity and less severe radiation enteritis than PR patients.Meanwhile,Faecalibacterium prausnitzii was significantly higher in RR patients than that in PR patients before radiotherapy(P<0.05),which may correlate negatively with radiation toxicity.Conclusions The characteristics of gut microbiota in patients with cervical and endometrial cancers were closely related to the severity of radiation enteritis they suffered during radiotherapy.Furthermore,prior treatment such as surgery might reduce radiation tolerance of the patients.

关 键 词：肠道微生物 宫颈癌 子宫内膜癌 放射治疗 放射性肠炎 

分 类 号：R737.33[医药卫生—肿瘤]