基于16SrRNA测序研究结直肠癌湿热瘀毒证舌苔微生态特征  

Study on Micro Ecological Characteristics of Tongue Coating of Colorectal Cancer with Damp-heat-blood Stasis-toxin Syndrome Based on 16SrRNA Sequencing

作　　者：徐思源 张钦畅 耿雪尘 孙珍珍 倪明欣 惠逸帆 孙晓荷 方妍 李柳 程海波 XU Si-yuan;ZHANG Qin-chang;GENG Xue-chen;SUN Zhen-zhen;NI Ming-xin;HUI Yi-fan;SUN Xiao-he;FANG-Yan;LI Liu;CHENG Hai-bo(The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing,210023;Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine in Prevention and Treatment of Tumor,Nanjing,210023)

机构地区：[1]南京中医药大学第一临床医学院,南京210023 [2]江苏省中医药防治肿瘤协同创新中心,南京210023 [3]江苏省丹阳市中医院肿瘤科,江苏212300

出　　处：《中国中西医结合杂志》2025年第1期32-41,共10页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-C-202208);国家中医药管理局高水平中医药重点学科建设项目(No.国中医药人教函〔2023〕85号);国家自然科学基金资助项目(No.81930117);江苏高校优势学科建设工程资助项目(No.苏政办发〔2018〕87号)。

摘　　要：目的探究结直肠癌患者湿热瘀毒证形成的生物学基础。方法筛选2021年11月—2022年11月100例结直肠癌患者及50名健康体检者,纳入41例结直肠癌湿热瘀毒证患者(SRYD组)、41例结直肠癌非湿热瘀毒证患者(FSRYD组)及40名健康人(Normal组)。采用16SrRNA测序技术,分析各组菌群的组成和多样性差异。结果SRYD组、FSRYD组和Normal组在丰富度和多样性上无显著差异。与FSRYD组和Normal组比较,在门水平上,SRYD组在厚壁菌门(Firmicutes)、放线菌门(Actinobacteriota)、迷踪菌门(Elusimicrobiota)、RCP2-54特异表达;在属水平上,SRYD组在罗尔斯通菌属(Ralstonia)、鞘鞍醇单胞菌属(Sphingomonas)、小杆菌属(Dialister)、棒状杆菌属(Corynebacterium)、罗氏菌属(Rothia)、臭杆菌属(Odoribacter)、链球菌属(Streptococcus)等特异表达。链球菌属(Streptococcus)可能作为结直肠癌湿热瘀毒证的潜在非侵入性生物标志物。基于LEfSe分析,发现厚壁菌门(p_Firmicutes)、放线菌门(p_Actinobacteriota)、链球菌科(f_Streptococcaceae)、链球菌属(g_Streptococcus)、放线菌纲(c_Actinobacteria)等是导致结直肠癌湿热瘀毒证患者舌苔变化的关键菌群。PICRUSt功能预测分析发现,SRYD组差异表达的功能主要富集的途径是磷酸转氨酶系统,缬氨酸、亮氨酸和异亮氨酸的降解,恶性肿瘤的中心碳代谢以及碳水化合物运输和代谢等方面。结论从舌苔菌群角度解读结直肠癌中医辨证分型具有一定的合理性。舌苔菌群的组成可以作为结直肠癌患者湿热瘀毒证的诊断指标。链球菌属(Streptococcus)可能作为结直肠癌湿热瘀毒证的潜在非侵入性生物靶标。Objective To explore the biological basis of the damp-heat-blood stasis-toxin syndrome in colorectal cancer(CRC)patients.Methods Totally 100 patients with CRC and 50 healthy individuals were screened.A total of 41 patients with CRC with damp heat stasis syndrome(SRYD),41 patients with CRC without damp heat stasis syndrome(FSRYD)and 40 healthy individuals(Normal)were enrolled.16S rRNA sequencing technology was used to analyze the differences in the composition and diversity of microbial groups.Results There was no significant difference in richness and diversity among SRYD,FSRYD and Normal groups.Compared with other groups,different expressions of Firmicutes,Actinobacteriota,Elusimicrobiota,RCP2-54 at phylum level,Ralstonia,Sphingomonas,Dialister,Corynebacterium,Rothia,Odoribacter,Streptococcus and so on at genus level were detected in SRYD groups.A possible non-invasive biomarker of damp-heat stasis and toxin syndrome in colorectal cancer may be Streptococcus.LEfSe analysis indicated a greater abundance of Firmicutes,Actinobacteriota,Streptococcaceae,Streptococcus,Actinobacteria,Granulicatella,Rothia,Corynebacteriales,Corynebacteriaceae,Corynebacterium in SRYD groups.PICRUSt functional predictive analysis indicated the primary enrichment pathway of the SRYD group's differential expression are phosphotransferase system,valine,leucine and isoleucine degradation,central carbon metabolism in cancer,carbohydrate transport and metabolism.Conclusions It is reasonable to analyze CRC Chinese medicine syndrome differentiation from the perspective of tongue coating flora.Tongue coating flora can be used to diagnose damp-heat-blood stasis-toxin syndrome in CRC patients.Streptococcus could be a noninvasive biomarker for damp-heat-blood stasis-toxin syndrome in CRC.

关 键 词：结直肠癌 舌象 舌苔菌群 中医证型 16SrRNA测序 中西医结合 

分 类 号：R273[医药卫生—中西医结合]