肠道菌群失调、炎症因子变化、维生素缺乏与肝癌患者根治术后复发的关系

The relationship between intestinal flora imbalance,inflammatory factor changes,vitamin deficiency and recurrence after radical operation in patients with liver cancer

目的:观察肝癌根治术后患者肠道菌群失调、炎症因子水平及维生素水平,分析其与术后复发的相关性。方法:选取2015年6月至2017年6月于我院行肝癌根治术患者120例,随访1年后,按照复发情况分为复发组和无复发组,测定两组患者的肠道菌群情况、炎症因子和维生素水平,采用Pearman相关性分析法对肠道细菌总负荷、炎症因子、维生素水平与AFP的相关性进行分析,P<0.05为差异有统计学意义。结果:复发组和无复发组在年龄、性别、基础肝脏疾病、肝功能分级、手术切除方式、术中肝门是否阻断、肿瘤最大直径及术后是否化疗等方面差异无统计学意义;复发组的炎症因子(PCT、CRP、IL-6)水平明显高于无复发组(P<0.05);复发组的AFP、AKP、ALT水平明显高于无复发组(P<0.05);复发组的维生素水平(25-羟维生素D3、维生素B12及维生素C)明显低于无复发组(P<0.05);复发组的细菌总负荷明显高于无复发组,其中双歧杆菌和乳酸杆菌两种益生菌菌种水平明显低于无复发组;细菌总负荷(r=0.792,P<0.001)、CRP(r=0.724,P<0.001)与AFP呈正相关,维生素C水平(r=-0.663,P<0.001)与AFP呈负相关。结论:肝癌术后是否复发与肠道菌群失调、炎症因子变化及维生素缺乏有着密切的关系。

Objective:To analyze the relationship between recurrence of liver cancer after radical resection and postoperative flora dissonance,inflammatory factor level and vitamin deficiency.Methods:120 patients were selected after radical resection of liver cancer in our hospital from June 2015 to June 2017.After one year of follow-up,recurrence was divided into recurrence group and non-recurrence group.Intestinal flora,inflammatory factors,liver function,and vitamin levels were measured in both groups.The correlation between total intestinal bacterial load,inflammatory factors,vitamin levels and AFP was analyzed by pearman correlation analysis.Results:The levels of inflammatory factors(PCT,CRP,IL-6),AFP,ALT and AKP were significantly higher in the relapse group than in the non-recurrence group(P<0.05).The vitamin levels of the relapse group(25-hydroxyvitamin D3,vitamin B12 and vitamin C) were significantly lower than those of the non-recurrence group(P<0.05).The total bacterial load of the recurrent group was significantly higher than that of the non-recurrent group,and the level of two probiotics,bifidobacterium and lactobacillus,was significantly lower than that of the non-recurrent group.Total bacterial load(r=0.792,P<0.001) and CRP(r=0.724,P<0.001) were positively correlated with AFP,while vitamin C level(r=-0.663,P<0.001) was negatively correlated with AFP.Conclusion:The recurrence of liver cancer after operation is closely related to the imbalance of intestinal flora,changes of inflammatory factors and vitamin deficiency.