结直肠癌患者粪便中短链脂肪酸特征分析  

Analysis of characteristics of short-chain fatty acids in feces of patients with colorectal cancer

作　　者：张斌 文波 刘正刚 陈代儒 喻远尤 李胜 ZHANG Bin;WEN Bo;LIU Zhenggang;CHEN Dairu;YU Yuanyou;LI Sheng(Shaoyang Hospital Affiliated to University of South China,Shaoyang 422000,China)

机构地区：[1]南华大学附属邵阳医院,湖南邵阳422000

出　　处：《临床医学研究与实践》2023年第7期1-4,9,共5页Clinical Research and Practice

基　　金：邵阳市科技计划项目(No.2021072ZD)。

摘　　要：目的分析结直肠癌(CRC)患者粪便中短链脂肪酸(SCFAs)特征,为疾病的早筛和治疗提供有用信息。方法选取2022年1月至7月南华大学附属邵阳医院胃肠外科收治的44例CRC患者(右半结肠癌20例,左半结肠癌24例)、42例结肠腺瘤性息肉(CAP)患者及体检中心40名健康人群,依次设为CRC组、CAP组、HP组。采用气相色谱-质谱联用法(GC-MS)测定粪便中SCFAs浓度。记录GC-MS检测结果;比较三组粪便中SCFAs浓度;比较右半结肠癌和左半结肠癌患者粪便中SCFAs浓度;采用偏最小二乘判别分析(PLS-DA)确定各组粪便中SCFAs特征。结果6种SCFAs在各自的线性范围内线性关系良好(R2≥0.9998)。与HP组比较,CRC组粪便中乙酸、丙酸、丁酸浓度及总SCFAs浓度降低,异戊酸浓度升高,差异具有统计学意义(P<0.05);与CAP组比较,CRC组粪便中丁酸浓度降低,差异具有统计学意义(P<0.05)。CAP组与HP组粪便中乙酸、丙酸、异丁酸、丁酸、异戊酸、戊酸浓度及总SCFAs浓度比较,差异无统计学意义(P>0.05)。右半结肠癌患者粪便中乙酸浓度及总SCFAs浓度高于左半结肠癌患者,差异具有统计学意义(P<0.05)。从PLS-DA模型可以看出CRC患者与健康人群分离较明显,而CAP患者位于CRC患者与健康人群之间,该模型未过度拟合,结合变量投影重要性(VIP)发现,乙酸、丙酸、丁酸可作为CRC潜在的诊断标志物。结论CAP患者粪便中SCFAs浓度介于CRC患者与健康人群之间,在一定程度上说明CRC是在肠道环境改变的基础上发生的。CRC患者粪便中总SCFAs浓度较健康人群明显降低,特别是乙酸、丙酸、丁酸可作为CRC早期筛查的潜在标志物。Objective To analyze the characteristics of short-chain fatty acids(SCFAs)in feces of patients with colorectal cancer(CRC),and provide useful information for early screening and treatment of the disease.Methods From January to July 2022,44 CRC patients(20 cases of right colon cancer,24 cases of left colon cancer),42 cases of colon adenomatous polyps(CAP)admitted in gastrointestinal surgery department and 40 healthy people in physical examination center of Shaoyang Hospital Affiliated to University of South China were selected and divided into CRC group,CAP group and HP group.The concentration of SCFAs in feces was determined by gas chromatography-mass spectrometry(GC-MS).The GC-MS detection results was record;the concentration of SCFAs in feces of the three groups was compared;the concentration of SCFAs in feces of patients with right colon cancer and left colon cancer was compared;partial least squares discriminant analysis(PLS-DA)was used to determine the characteristics of SCFAs in feces of each group.Results Six SCFAs had good linear relationship within their respective linear range(R2≥0.9998).Compared with the HP group,the concentration of acetic acid,propionic acid,butyric acid and total SCFAs in feces of the CRC group decreased,while the concentration of isovaleric acid increased,and the differences were statistically significant(P<0.05);compared with the CAP group,the concentration of butyric acid in feces of the CRC group decreased,and the difference was statistically significant(P<0.05).There were no significant differences in the concentrations of acetic acid,propionic acid,isobutyric acid,butyric acid,isovaleric acid,valeric acid and total SCFAs in feces between the CAP group and the HP group(P>0.05).The concentration of acetic acid and total SCFAs in feces of patients with right colon cancer was higher than that of patients with left colon cancer,and the differences were statistically significant(P<0.05).The PLS-DA model showed that the separation between CRC patients and healthy people was obvious

关 键 词：结直肠癌 结肠腺瘤性息肉 短链脂肪酸 气相色谱-质谱联用法 

分 类 号：R735.3[医药卫生—肿瘤]