艰难梭菌感染与大肠癌及大肠腺瘤的相关性分析

Correlation between Clostridium difficile infection and colorectal cancer and colorectal adenoma

目的分析艰难梭菌感染与大肠癌及大肠腺瘤的相关性,为临床预防及治疗肠道肿瘤提供新思路。方法收集2016年1月至2017年6月于甘肃省人民医院就诊的134例大肠癌患者、52例大肠腺瘤患者及100例健康对照者的粪便标本及临床资料,对粪便标本进行细胞毒性试验检测,分析大肠癌及大肠腺瘤与艰难梭菌感染的相关性。同时分析艰难梭菌感染与大肠癌临床特征及部分样本免疫组化(Her-2、P53、CDX2、CD56及Ki-67)结果的相关性。结果 (1)结直肠癌组检出13例艰难梭菌感染者(9.70%),大肠腺瘤组检出2例艰难梭菌感染者(3.85%),对照组未检出艰难梭菌感染者。结直肠癌组艰难梭菌感染率明显高于大肠腺瘤组及对照组(χ~2=11.0953,P<0.05)。(2)艰难梭菌感染与结直肠癌病理分期具有相关性,其中Ⅰ、Ⅱ期共检出1例感染者(1.9%),Ⅲ、Ⅳ期共检出12例感染者(14.8%),二者差异有统计学意义(χ~2=3.8963,P<0.05)。艰难梭菌感染与结直肠癌大体位置、大体形态、组织学分型、分化程度均无相关性(P>0.05)。(3)CDX2的表达与艰难梭菌感染具有相关性,CDX2阴性结直肠癌患者艰难梭菌感染率明显高于CDX2阳性患者(20.8%vs 2.8%,χ~2=8.5224,P<0.05);艰难梭菌感染与Her-2、P53、CD56及Ki-67之间无相关性(P>0.05)。结论艰难梭菌感染与大肠癌的发生具有相关性,特别是与大肠癌病理分期及CDX2表达存在相关性。艰难梭菌感染与大肠腺瘤之间无显著相关性。

Objective To analyze the relationship between Clostridium difficile infection and colorectal cancer and colorectal adenoma, and provide new ideas for clinical prevention and treatment of intestinal tumors. Methods Samples and clinical data were collected from 134 cases of colorectal cancer, 52 cases of colorectal adenoma and 100 healthy individuals from January 2016 to June 2017. Cellular toxicity test was performed to detect the fecal samples. The relationship between Clostridium difficile infection and clinical features of colorectal cancer and immunohistochemical results （Her-Z, P53, CDX2, CD56 and Ki-67） of some samples were analyzed. Results （1） The detection rate of Clostridium difficile in colorectal cancer group （13 cases, 9.70% ） was significantly higher that in the colorectal adenoma group （2 cases, 3.85% ） or in the control group （0 case, 0.00%） （X^2 =11. 0953, P〈0.05） . （2） The pathological staging of colorectal cancer had a correlation with Clostridium difficile infection. 1 case （1.9 %） of Clostridium difficile infec- tion and 12 cases （14.8%） of Clostridium difficile infection were found in stage I and II cases and in stage III and IV cases, respectively （X^2 = 3. 8963, P（0.05） . There was no correlation between Clostridium difficile infection and eolorectal cancer in respect with the location, morphology, histological type and dif- ferentiation degree （P〉0.05） . （3） The expression of CDX2 was associated with Clostridium difficile in- fection. The rate of Clostridium difficile infection in CDX2 negative colorectal cancer was significantly higher than that in CDX2 positive cases （20.8% vs 2.8%,X^2 =8. 5224, P（0.05） . There was no correla- tion between Clostridium difficile infection and each of Her-2, P53, CD56 and Ki-67 （P〉0. 05） . Conclusion Clostridium difficile infection is related to colorectal cancer, especially to the pathological staging and the expression of CDX2. There is no correlation between Clostridium difficile infection and colorectal adenoma.