结直肠癌及肠道腺瘤性息肉患者肠道菌群失调情况及相关危险因素分析

Analysis of Alteration of Intestinal Flora and Related Risk Factors in Patients with Colorectal Cancer Combined with Colorectal Adenomatous Polyps

目的分析结直肠癌及结直肠腺瘤性息肉患者肠道菌群失调情况及相关危险因素。方法选择海军总医院2015年1—12月收治的150例患者为研究对象,其中A组为早期结直肠癌,B组为结直肠腺瘤性息肉,C组为早期结直肠癌合并腺瘤性息肉,每组50例。分别于就诊时、术后(外科手术或肠镜下手术)1个月、3个月、6个月对患者肠道菌群进行检测,并分析各组肠道菌群失调危险因素。结果 3组在不同时间段肠镜活检样本中双歧杆菌(Bdb)和肠杆菌(EMB)计数比较差异均有统计学意义(P<0.01)。在相同时间点,3组间肠镜活检样本中Bdb计数比较差异均有统计学意义(P<0.01)。而在术后1个月时3组间肠镜活检样本中EMB计数比较差异有统计学意义(P<0.05)。同时3组肠道菌群失调发生率比较差异无统计学意义(P>0.05)。二分类Logistic回归分析提示BMI异常、服药史均为3组发生肠道菌群失调的危险因素(P<0.05,P<0.01)。此外年龄亦为B组肠道菌群失调的危险因素(P<0.01)。结论肠道菌群失调在结直肠癌及结直肠腺瘤性息肉患者中表现出显著性差异,其中Bdb减少更为突出,进一步佐证肠道菌群失调在结直肠癌发生、发展中起到重要作用。

Objective To analyze alteration of intestinal flora and related risk factors in patients with colorectal cancer combined with eolorectal adenomatous polyps. Methods A total of 150 patients admitted from January to October 2015 were recruited in this study. Patients in group A had early colorectal cancer; patients in group B had colorectal adenomatous polyps ; patients in group C had early colorectal cancer combined with colorectal adenomatous polyps （ n = 50 for each group）. Conditions of intestinal flora were detected at the time of visiting, and in 1st, 3rd and 6th months after surgery （surgery or endoscopic surgery）, and risk factors of alteration of intestinal flora in each group were analyzed. Results There were significant differences in bacillus bifidus （Bdb） and enterobacteria （EMB） counts of colorectal biopsy samples among the three groups at different times （P 〈 0.01 ）. At the same time point, the differences in Bdh counts of colorectal biopsy samples among the three groups were statistically significant （P 〈 0.01 ）. There were significant differences in EMB counts of colorectal biopsy samples among the three groups 1st month after surgery （P 〈 0.05）. There were no significant differences in incidence rate of alteration of intestinal flora among the three groups （ P 〉 0.05 ）. Binary Logistic regression analysis showed that abnormal BMI, and medication history was risk factor of aheration of intestinal flora in the three groups （P 〈 0.05, P 〈 0.01 ）. The age was also risk factor of alteration of intestinal flora in group B （P 〈 0. 01 ）. Conclusion Alteration of intestinal flora shows significant difference in patients with colorectal cancer combined with colorectal adenomatous, and decreased Bdb is more prominent, and then further evidence shows that alteration of intestinal flora plays an important role in development of colorectal cancer.