肠道微生物群落与晚期大肠癌化疗患者预后的关系

Relationship between intestinal microbial community and prognosis in patients with advanced colorectal cancer chemotherapy

目的分析肠道微生物群落与大肠癌化疗患者预后的相互关系。方法选取2013-2016年符合晚期大肠癌诊断标准的106位患者,采用随机数字表法将其分为实验组和对照组。对照组予以奥沙利铂+希罗达(XELOX)方案化疗,实验组在对照组基础上口服双歧杆菌三联活菌胶囊至化疗结束。分别于化疗前后对两组患者肠道微生物群落进行微生物计数,并记录两组患者化疗后的不良反应。采用欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-C30)评估患者治疗前后生活质量,随访并记录入组患者的总生存时间(OS)。结果两组在年龄、体重指数(BMI)、家族史等一般情况差异均无统计学意义(P>0.05)。治疗前,两组患者各肠道微生物群落数量比较差异均无统计学意义(P>0.05)。治疗后,实验组患者的双歧杆菌、乳酸杆菌、葡萄球菌数量较治疗前差异有统计学意义(P<0.05),对照组双歧杆菌、乳酸杆菌、肠球菌数量较治疗前差异有统计学意义(P<0.05)。与对照组比较,治疗后的实验组双歧杆菌、乳酸杆菌、葡萄球菌数量差异有统计学意义(P<0.05),实验组患者恶心、呕吐及腹泻发病率显著降低(P<0.05)。实验组中位生存期(MST)为37个月,对照组MST为26个月,治疗后患者生活质量有明显的好转(P<0.05)。结论肠道微生物群落与晚期大肠癌化疗患者的预后有一定关系,益生菌治疗不仅可以降低大肠癌患者化疗后肠道并发症的发生率,还可以通过提高化疗的疗效提高患者的生存质量及生存时间。

Objective To analyze the relationship between intestinal microbial community and prognosis of patients with colorectal cancer chemotherapy. Methods A total of 106 patients who met the diagnostic criteria for advanced colorectal cancer during 2013 and 2016 were selected and randomly divided into observation group or control group. All patients were given chemotherapy with Oxaliplatin+Xeloda(XELOX);those in the observation group were additionally given bifidobacterium triple viable capsule orally till the end of chemotherapy. The intestinal microflora in both groups were counted before and after chemotherapy, and the adverse reactions after chemotherapy were recorded. The European Organization for the Research and Treatment of Cancer quality of life questionnaire(EORTC QLQ-C30) was used to evaluate the quality of life of patients before and after treatment. Follow-up was conducted and the patients′ overall survival(OS) was recorded. Results There were no statistically significant differences in the general conditions such as age, body mass index(BMI) and family history between the two groups(all P>0.05). Before treatment, there were no significant differences in the counts of intestinal microbial communities between the two groups(P>0.05). The counts of bifidobacteria, lactobacilli and staphylococci in the observation group after treatment was statistically different compared with that before treatment(P<0.05);while in the control group, the counts of bifidobacteria, lactobacilli and enterococci were statistically different compared with that before treatment(P<0.05). The counts of bifidobacteria, lactobacilli and staphylococci in the observation group after treatment were statistically different compared with the control group(P<0.05). After treatment, the incidences of nausea, vomiting and diarrhea in the observation group significantly reduced(P<0.05). The median survival time(MST) in the observation group was 37 months, while the MST in the control group was 26 months. After treatment, the quality of life of patients improved significantly(P<0.05). Conclusion There is a certain relationship between intestinal microbial community and the prognosis of patients with advanced colorectal cancer chemotherapy. Probiotic therapy can not only reduce the incidence of intestinal complications in patients with colorectal cancer after chemotherapy, but also improve the quality of life and survival time of patients by improving the efficacy of chemotherapy.