溧阳市新确诊结直肠癌病例肠道菌群特征研究

doi:10.12183/j.scjpm.2021.1528

摘要/Abstract

摘要： 目的探讨溧阳市新确诊结直肠癌病例肠道菌群特征。方法选取150例新确诊结直肠癌（结直肠癌组）及150例健康体检者（对照组）,提取新鲜粪便中纯化基因DNA后采取聚合酶链反应扩增,采用16S rDNA高通量测序,同时将粪便样本接种于培养基中进行细菌培养,对菌群进行鉴定及计数。结果结直肠癌患者中男性84例,女性66例,年龄32~75岁,平均（56.88±8.74）岁。NM分期：Ⅰ期26例、Ⅱ期94例、Ⅲb期30例。对照组中男性79人、女性71人,年龄30~68岁,平均（56.73±8.28）岁。2组性别及年龄比较差异均无统计学意义（均P>0.05）。16S rDNA高通量测序结果,结直肠癌组Shannon指数及Chao指数表达水平明显低于对照组,差异均有统计学意义（均P<0.01）,结直肠癌组患者厚壁菌门丰度低于对照组,拟杆菌门、变形菌门、梭杆菌门、放线菌门丰度值高于对照组,差异均有统计学意义（均P<0.01）。细菌培养结果显示,结直肠癌组患者肠道内大肠杆菌、肠球菌、葡萄球菌数量明显高于对照组,双歧杆菌、乳酸杆菌、消化球菌、酵母菌数量明显低于对照组,差异均有统计学意义（均P<0.01）。结论溧阳市新诊断结直肠癌患者肠道菌群与健康人群比较多样性明显下降,患者厚壁菌门水平丰度下降,而拟杆菌门、变形菌门、梭杆菌门、放线菌门丰度升高,双歧杆菌、乳酸杆菌等益生菌数减少,大肠杆菌、肠球菌等条件致病菌数量增加。

关键词: 消化系统, 结直肠癌, 肠道菌群

Abstract: Objective To investigate the characteristics of intestinal flora in newly diagnosed cases of colorectal cancer in Liyang City. Methods One hundred and fifty cases of newly diagnosed colorectal cancer （colorectal cancer group） and 150 healthy persons （control group） were selected, DNA was purified from fresh feces and amplified by polymerase chain reaction. 16S rDNA high-throughput sequencing was performed, fecal samples were inoculated in the culture medium for bacterial culture, and the bacterial community was identified and counted. Results Among the patients with colorectal cancer, 84 were males and 66 were females, aged 32-75 years old, with an average age of （56.88±8.74） years old. NM staging： 26 cases in stage Ⅰ, 94 cases in stage Ⅱ, 30 cases in stage Ⅲb. In the control group, there were 79 males and 71 females, aged 30-68 years old, with an average age of （56.73±8.28） years old. There was no significant difference in gender and age between the two groups （both P>0.05）. The results of 16S rDNA high-throughput sequencing showed that the Shannon index and Chao index in the colorectal cancer group was significantly lower than that in control group, the difference was statistically significant （both P<0.01）. The abundance of Firmicutes in colorectal cancer group was lower than that in control group, the abundance of Bacteroidetes, Proteobacteria, Clostridium and Actinomycetes was higher than that in control group, the difference was statistically significant （all P<0.01）. Bacterial culture results showed that the number of Escherichia coli, Enterococcus and Staphylococcus in the intestinal tract of colorectal cancer group was significantly higher than that of the control group, the number of Bifidobacterium, Lactobacillus, Peptococcus and Yeast was significantly lower than that of the control group, the difference was statistically significant （all P<0.01）. Conclusion The diversity of intestinal flora in newly diagnosed colorectal cancer patients is significantly lower than that in healthy people in Liyang City, the abundance of Firmicutes decreased, while the abundance of Bacteroidetes, Proteobacteria, Clostridium and Actinomycetes increased, the number of probiotics such as Bifidobacterium and Lactobacillus decreased, and the number of opportunistic pathogens such as Escherichia coli and Enterococcus increased.

Key words: Digestive system, Colorectal cancer, Intestinal flora

中图分类号:

R181.3+7

潘静, 姚国忠, 张洪志, 范双华. 溧阳市新确诊结直肠癌病例肠道菌群特征研究[J]. 华南预防医学, 2021, 47(12): 1528-1531.

PAN Jing, YAO Guo-zhong, ZHANG Hong-zhi, FAN Shuang-hua. Characteristics of intestinal flora in newly diagnosed cases of colorectal cancer in Liyang[J]. South China Journal of Preventive Medicine, 2021, 47(12): 1528-1531.

参考文献

[1] 王锡山. 中美结直肠癌流行病学特征对比及防控策略分析[J]. 中华结直肠疾病电子杂志, 2019, 8(1):7-11.
[2] 郭天安, 谢丽, 赵江, 等. 中国结直肠癌1988—2009年发病率和死亡率趋势分析[J]. 中华胃肠外科杂志, 2018,21(1):33-40.
[3] Laissue P.The forkhead-box family of transcription factors: Key molecular players in colorectal cancer pathogenesis[J]. Mol Cancer, 2019, 18(1): 1-13.
[4] 梁大艳,林绍良,陈剑雄,等.2014—2016年肇庆市端州区恶性肿瘤发病与死亡分析[J].华南预防医学,2021,47(8):968-971.
[5] 李超,王琳.郑州市25 986例消化道肿瘤病例疾病谱分析[J].华南预防医学,2021,47(7):889-891.
[6] Zhang H, Chang Y, Zheng Q, et al.Altered intestinal microbiota associated with colorectal cancer[J]. Front Med, 2019, 13(4): 461-470.
[7] 樊逸夫,白晓敏,杜娟.肠道菌群对肿瘤影响的研究进展[J].癌症进展,2019,17(15):1741-1744.
[8] Seesaha PK, Chen X, Wu X, et al.The interplay between dietary factors, gut microbiome and colorectal cancer: A new era of colorectal cancer prevention[J]. Future Oncol, 2020, 16(7): 293-306.
[9] 索明果,范筱,李英宽,等.肠道腺瘤性息肉和结直肠癌患者肠道菌群变化及其差异[J].河南医学研究,2020,29(18):3302-3303.
[10] Rawla P, Sunkara T, Barsouk A.Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors[J]. Przeglad gastroenterologiczny, 2019, 14(2): 89.
[11] Araghi M, Soerjomataram I, Bardot A, et al.Changes in colorectal cancer incidence in seven high-income countries: A population-based study[J]. Lancet Gastroenterol Hepatol, 2019, 4(7): 511-518.
[12] White A, Ironmonger L, Steele RJC, et al.A review of sex-related differences in colorectal cancer incidence, screening uptake, routes to diagnosis, cancer stage and survival in the UK[J]. BMC Cancer, 2018, 18(1): 1-11.
[13] 张英丽,陈倩倩,刘颖.微生态制剂在早期结直肠癌根治术后的作用[J].中国微生态学杂志,2020,32(10):1167-1172.
[14] Gursoy S, Koçkar T, Atik SU, et al.Autoimmunity and intestinal colonization by Candida albicans in patients with type 1 diabetes at the time of the diagnosis[J]. Korean J Pediatr, 2018, 61(7): 217.
[15] Yue T, Lu HY, Xue ZY, et al.Structural features of intestinal flora in preterm rats with cognitive impairment: An analysis based on high-thorough sequencing[J]. Chin J Contemp Pediatr, 2019, 21(7): 701-707.
[16] Ibrahim A, Hugerth LW, Hases L, et al.Colitis‐induced colorectal cancer and intestinal epithelial estrogen receptor beta impact gut microbiota diversity[J]. Int J Cancer, 2019, 144(12): 3086-3098.
[17] 夏周琦, 庚天琦, 李霞,等. 肠道菌群与结直肠癌的关系[J]. 国际遗传学杂志, 2021, 44(4):238-245.
[18] Yamaoka Y, Suehiro Y, Hashimoto S, et al.Fusobacterium nucleatum as a prognostic marker of colorectal cancer in a Japanese population[J]. J Gastroenterol, 2018, 53(4): 517-524.
[19] Yamamoto S, Kinugasa H, Hirai M, et al.Heterogeneous distribution of Fusobacterium nucleatum in the progression of colorectal cancer[J]. J Gastroenterol Hepatol, 2021, 36(7): 1869-1876.
[20] Datorre JG, de Carvalho AC, Guimaraes DP, et al. The role of Fusobacterium nucleatum in colorectal carcinogenesis[J]. Pathobiology, 2021, 88(2): 127-140.
[21] Pleguezuelos-Manzano C, Puschhof J, Huber AR, et al.Mutational signature in colorectal cancer caused by genotoxic pks+ E. coli[J]. Nature, 2020, 580(7802): 269-273.
[22] Thakur BK, Malaisé Y, Martin A.Unveiling the mutational mechanism of the bacterial genotoxin colibactin in colorectal cancer[J]. Molecular cell, 2019, 74(2): 227-229.
[23] Lopes A, Billard E, Casse AH, et al.Colibactin-positive Escherichia coli induce a procarcinogenic immune environment leading to immunotherapy resistance in colorectal cancer[J]. Int J cancer, 2020, 146(11): 3147-3159.
[24] Haghi F, Goli E, Mirzaei B, et al.The association between fecal Enterotoxigenic B. fragilis with colorectal cancer[J]. BMC Cancer, 2019, 19(1): 1-4.
[25] 黄奔,范维,王萍,等.肿瘤坏死因子α在恶性肿瘤诊疗中的研究进展[J].分子诊断与治疗杂志,2021,13(9):1377-1380.