基于中医“瘤毒内生”理论探讨Ⅲ-Ⅳ期铂耐药卵巢癌脂代谢与肠道菌群的特征  

The characteristic analysis of lipid metabolism and intestinal flora in platinum-resistant ovarian cancer at stageⅢ-Ⅳbased on the theory of“tumour toxicity”in traditional Chinese medicine

作　　者：江海丽 叶映泉 胡蝶 盛锐 高朝政 占淑祺 张梅[1,2] 王婷[1,2] Jiang Haili;Ye Yingquan;Hu Die;Sheng Rui;Gao Chaozheng;Zhan Shuqi;Zhang Mei;Wang Ting(Dept of Integrated Chinese and Western Medicine Oncology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Center of Integrated Chinese and Western Medicine Oncology,Anhui Medical University,Hefei 230032;Graduate School,Anhui Medical University,Hefei 230032;Graduate School,Anhui University of Chinese Medicine,Hefei 230012)

机构地区：[1]安徽医科大学第一附属医院中西医结合肿瘤科,合肥230022 [2]安徽医科大学中西医结合肿瘤中心,合肥230032 [3]安徽医科大学研究生院,合肥230032 [4]安徽中医药大学研究生院,合肥230012

出　　处：《安徽医科大学学报》2024年第10期1863-1870,共8页Acta Universitatis Medicinalis Anhui

基　　金：安徽省卫生健康科研项目(编号:AHWJ2023BAc20005)。

摘　　要：目的通过比较Ⅲ-Ⅳ期卵巢癌铂耐药与铂敏感患者脂代谢的差异,并采用16S rRNA测序技术分析差异肠道菌群,探讨肠道菌群、脂代谢特征与卵巢癌铂耐药之间的关联性,以期指导铂耐药卵巢癌的临床治疗。方法选取经手术病理诊断为Ⅲ-Ⅳ期的卵巢癌,铂耐药组(11例)和铂敏感组(11例)。比较组间脂代谢的差异;粪便16S rRNA测序探讨两组肠道菌群的差异,分析肠道菌群、脂代谢特征与卵巢癌铂耐药之间的关联性。结果铂耐药组脂代谢指标[总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(n-HDL)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白(B)]高于铂敏感组;两组之间的Shannon指数(P=0.0083)、Simpson指数(P=0.0082)均显示铂耐药组患者肠道菌群多样性高于铂敏感组,但基于物种聚类(OTUs)和相对丰度统计显示,铂敏感卵巢癌肠道副拟杆菌属(Parabacteroides)、阿克曼菌属(Akkermansia)、布劳特氏菌属(Blautia)、乳酸梭菌属(Lachnoclostridium)、梭菌杆菌(Fusicatenibacter)、巨单胞菌属(Megamonas)等物种丰度显著高于铂耐药组,其中阿克曼菌属(脂代谢相关菌群)占比最高。结论卵巢癌铂耐药组脂代谢水平和肠道菌群多样性显著高于铂敏感组,提示脂代谢水平、粪便微生物多样性的增加可能与铂耐药的发生相关;但铂耐药组中某些菌群丰度的减少,如差异明显的阿克曼菌属(脂代谢相关菌群),可能作为诱发卵巢癌铂耐药的因素之一。Objective To compare the differences in lipid metabolism between platinum-resistant and platinum-sensitive ovarian cancer patients at stageⅢ-Ⅳ,to analyze the differential intestinal flora using 16S rRNA sequencing,and to explore the associations among intestinal flora,lipid metabolism characteristics and platinum resistance in ovarian cancer.Methods Patients diagnosed with ovarian cancer at stageⅢ-Ⅳthrough surgical pathology were selected,including a platinum-resistant group(11 cases)and a platinum-sensitive group(11 cases).The differences in lipid metabolism between the two groups were compared.The differences in gut microbiota between the two groups were investigated using fecal 16S rRNA sequencing.The association among gut microbiota,lipid metabolism characteristics,and platinum resistance in ovarian cancer was analyzed.Results Significant differences were observed in lipid metabolism-related indicators[total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),non-high-density lipoprotein cholesterol(n-HDL),low-density lipoprotein cholesterol(LDL-C),apolipoprotein(B)]between the two groups,with higher levels in the platinum-resistant group.The Shannon index(P=0.0083)and Simpson index(P=0.0082)both showed higher diversity of gut microbiota in platinum-resistant ovarian cancer patients compared to the platinum-sensitive group.However,based on OTUs species clustering and relative abundance statistics,certain bacterial abundances differed significantly between the groups.Species such as Parabacteroides,Akkermansia,Blautia,Lachnoclostridium,Fusicatenibacter,and Megamonas had significantly higher abundances in the platinum-sensitive ovarian cancer group,and Akkermansia(a lipid metabolism-related bacterial group)was the most prevalent.Conclusion The platinum-resistant group of ovarian cancer exhibits significantly higher levels of lipid metabolism and gut microbiota diversity compared to the platinum-sensitive group.This suggests that the increase in lipid metabolism levels and fecal microbiota divers

关 键 词：卵巢癌 铂敏感 铂耐药 肠道菌群 脂代谢 

分 类 号：R737.31[医药卫生—肿瘤]