胃癌患者化疗期间肠道菌群特征与腹泻发生风险的相关性  

Correlation between intestinal flora characteristics and diarrhea risk in patients with gastric cancer during chemotherapy

作　　者：杨静静 周婷婷 赵海霞[1] Yang Jingjing;Zhou Tingting;Zhao Haixia(Department of Oncology,the First People's Hospital of Huai'an,Huai'an 223300,Jiangsu China)

机构地区：[1]淮安市第一人民医院肿瘤内科,江苏淮安223300

出　　处：《肿瘤代谢与营养电子杂志》2023年第6期800-806,共7页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：江苏省医院协会医院管理创新研究课题(JSYGY-1-2019-404)。

摘　　要：目的探讨胃癌患者化疗期间肠道菌群特征与腹泻发生风险的相关性。方法选取2018年8月至2022年2月淮安市第一人民医院肿瘤内科收治的120例接受胃癌根治术的患者为研究对象,术后所有患者均接受化疗,以化疗期间是否发生腹泻分为发生组和未发生组。采集所有患者新鲜成形粪便通过16S rDNA基因测序测定肠道菌群,对比两组肠道菌群特征以及肠道菌群组成及差异,采用多因素Logistic回归分析影响腹泻发生的相关因素;绘制受试者操作特征(ROC)曲线,通过曲线下面积(AUC)分析肠道菌群特征对化疗腹泻的指导价值。结果采用16S rDNA基因测序对120例粪便菌群样本分析,发生组Shannon指数(2.92±0.43)、Simpson指数(1.71±0.63)、Chao1指数(781.26±124.26)以及Ace指数(7635.26±225.74)和未发生组(2.38±0.61)、(1.95±0.72)、(715.26±147.25)、(7706.68±2534.68)对比差异无统计学意义(P>0.05),发生组Beta多样性(0.31±0.10)低于未发生组(0.46±0.13),(P<0.05)。患者粪便菌群序列主要分属于4个菌门,包括放线菌门(Proteobacte-ria)、厚壁菌门(Firmicutes)、拟杆菌门(Bacteroidetes)、变形菌门(Proteobacteria)。发生组放线菌门(5.56±1.05)、厚壁菌门(69.64±2.06)、拟杆菌门(16.75±2.19)以及变形菌门(18.26±2.74)和未发生组(4.42±0.74)、(72.65±1.54)、(12.17±1.15)、(7.68±1.36)组成差异组间对比具有统计学意义(P<0.05)。多因素Logistic回归结果显示Beta多样性(OR=1.320,95%CI=1.110~1.570)是腹泻发生的危险因素,拟杆菌门(OR=0.761,95%CI=0.629~0.921)以及放线菌门(OR=0.255,95%CI=0.120~0.542)是腹泻发生的保护因素(P<0.05)。结论对于接受化疗的胃癌患者而言,肠道菌群多样性的改变以及组成是化疗期间腹泻发生的相关因素,因此可通过肠道菌群的改变有针对性地予以用药指导。Objective To explore the correlation between intestinal flora characteristics and diarrhea risk in patients with gastric-cancer during chemotherapy.Method 120 patients with gastric cancer who underwent radical gastrectomy from August 2018 to February 2022 in the Department of Oncology of the First People's Hospital of Huai'an were selected as the research object.All patients received chemotherapy after operation,and were divided into two groups according to whether diarrhea occurred during chemotherapy or not.The intestinal flora was determined by 16S rDNA gene sequencing,and the characteristics,composition and differences of intestinal flora were compared between the two groups.The related factors affecting diarrhea were analyzed by multivariate Logistic-regression.Draw receiver operating characteristic curve(ROC),and analyze the characteristics of intestinal flora through the area under the curve(AUC)to guide the chemotherapy diarrhea.Result 16S rDNA gene sequencing was used to analyze 120 fecal flora samples,Shannon's index(2.92±0.43),Simpson's index(1.71±0.63),Chao1's index(781.26±124.26)and Ace index(7635.26±225.74)in the occurrence group and those in the non-occurrence group(2.38±0.61).(1.95±0.72).(715.26±147.25).(7706.68±2534.68).There was no significant difference(P>0.05).The Beta diversity in the occurrence group(0.31±0.10)was lower than that in the non-occurrence group(0.46±0.13)(P<0.05).The sequence of patients'fecal flora mainly belongs to four phyla,including Proteobacteria,Firmicutes,Bacteroidetes and Proteobacteria.In the occurrence group,Actinomycetes(5.56±1.05),Firmicutes(69.64±2.06),Bacteroides(16.75±2.19),Proteobacteria(18.26±2.74)and non-occurrence groups(4.42±0.74),(72.65±1.55).Multivariate Logistic regression results showed that Beta diversity(OR=1.320,95%CI=1.110-1.570)was the risk factors for diarrhea,Bacteroides(OR=0.761,95% CI=0.629-0.921)and Actinomycetes(OR=0.255,95%CI=0.120-0.521)were a protective factor in the occurrence of diarrhea.Conclusion For patients with gastri

关 键 词：腹泻 肠道菌群 化疗 风险 相关性 

分 类 号：R735.2[医药卫生—肿瘤]