弥漫大B细胞淋巴瘤患者肠道菌群动态分析

Dynamic analysis of the intestinal flora in patients with diffuse large B-cell lymphoma

目的:追踪1例弥漫大B细胞淋巴瘤,观察该患者肠道菌群结构的动态变化,研究肠道菌群与疾病进展的联系。方法:收集1例初诊血液恶性肿瘤中的弥漫大B细胞淋巴瘤患者入院当天、第16天时第1次化疗及第30天时第2次化疗后样本,通过16S rDNA技术分析肠道菌群多样性和差异性。结果:初诊时肠道菌群分布主要为韦荣球菌属、拟杆菌属、粪杆菌属、萨特菌属、链球菌和普氏菌属。16 d后韦荣球菌属、拟杆菌属、普氏菌属占优势。30 d后菌群主要为梭状芽孢杆菌属、拟杆菌属及布劳特氏菌。该例血液恶性肿瘤淋巴瘤患者厚壁菌门丰度始终占明显优势,而益生菌双歧杆菌属及乳杆菌属始终丰度极低,随疾病的进展,梭杆菌门几乎消失。粪球菌属及布劳特氏菌随病情进展逐渐上升,梭状芽孢杆菌属及大肠埃希菌属总体也呈上升趋势。萨特菌属、链球菌、副杆菌属明显下降,普氏菌属、小杆菌属及梭杆菌属及丁酸球菌属几乎消失。香茅梭菌增加,益生菌狄氏副杆菌及Butyricicoccus pullicaecorum减少。而被认为与肿瘤细胞凋亡有关的糖精梭菌增加,考虑与治疗有效相关。结论:随病程的进展,血液恶性肿瘤患者的肠道菌群结构发生改变,可为血液恶性肿瘤的治疗方案提供新思路。

Objective:To follow and observe the dynamic changes of intestinal flora components in one patient of diffuse large B lymphoma for the relationship between intestinal flora and the disease progression.Methods:Samples were collected from one patient with diffuse large B-cell lymphoma on the day of admission,16 days after the first chemotherapy and 30 days following second chemotherapy.Then the diversity and difference of intestinal flora were analyzed via 16s rDNA sequencing.Results:The intestinal bacteria for the patient consisted of Veillonella,Bacteroides,Faecalibacterium,Sutterella,Streptococcus and Prevotella at the initial diagnosis,yet Veillonella and Prevotella,Clostridium and Bacteroides and Blautia were dominated after 16 and 30 days,respectively.Strong Firmicutes were seen in this patient,while Bifidobacillus and Lactobacillus remained in lower level.Fusobacteria nearly vanished,yet Coprococcus and Blautia were on the rise with disease progression,and Clostridium and Escherichia tended to increase.Sutterella,Streptococcus and Parabacteroides were significantly decreased.In addition,Prevotella,Dialister,Fusobacterium and Butyricicoccus were almost disappeared,and Escherichia coli and Clostridium citroniae were increased with disease advancing.Decreased Parabacteroides distasonis and Butyricicoccus pullicaecorum were considered to be result of effective therapy,leading to increase of Clostridium saccharin associated with apoptosis of tumor cells.Conclusion:The intestinal flora may change in patient of hematologic malignancy with disease progression.The findings may provide new ideas for the treatment of such patients.