乳腺癌病人焦虑抑郁情绪与肠道菌群的相关性研究

Correlation between anxiety-depression emotion and intestinal flora in patients with breast cancer

目的:探讨乳腺癌病人肠道菌群物种多样性、丰度等方面差的异性,分析乳腺癌病人肠道菌群与焦虑抑郁情绪的相关性。方法:选择2019年10月至2020年10月安徽省蚌埠医学院第一附属医院肿瘤外科收治的乳腺癌病人30例,同期选取本院健康体检中心体检人员15例,依据焦虑自评量表、抑郁自评量表评分将研究对象分为乳腺癌有焦虑抑郁情绪组(BCAD组)、乳腺癌无焦虑抑郁情绪组(BCWAD组),非乳腺癌无焦虑抑郁情绪组(HWAD组),每组各15人。收集三组人群粪便标本进行测序,并进行肠道菌群和焦虑抑郁情绪相关性分析。结果:BCAD组焦虑得分(58.80±5.27)分、抑郁得分(59.60±4.94)分,BCWAD组焦虑得分(36.53±4.52)分、抑郁得分(38.20±3.78)分,HWAD组焦虑得分(35.13±5.28)分、抑郁得分(32.33±4.37)分,差异有统计学意义(P <0.05);高通量测序并生物信息学分析,三组的Shannon指数、Chao指数、Ace指数、Shannoneven指数和Coverage指数有统计学意义(P <0.05),Simpson指数无统计学意义(P> 0.05);群落差异分析三组肠道菌群在门属水平有不同细菌存在差异(P <0.05)。BCAD组肠道主要作用菌群为unclassified-Lachnospiracea、Sutterellaceae、Desulfovibrionales、Escherichia-Shigella,BCWAD组肠道主要作用菌群为Lactobacillus、Flavonifractor菌属。Pearson分析显示Campylobacterales、Helicobacteraceae、Anaerolineaceae等抑郁评分呈显著正相关,与焦虑评分不相关性(P>0.05)。结论:乳腺癌有焦虑抑郁情绪病人肠道菌群多样性及丰度降低,在门属水平上有一定差异,主要作用菌群为unclassified-Lachnospiracea、Campylobacterales、Helicobacteraceae,提示菌群结构的差异可能在乳腺癌焦虑抑郁情绪发生中起一定作用。

Objective: To explore the differences on species diversity and abundance of intestinal flora in breast cancer patients with or without anxiety-depression. correlation between patients’ intestinal flora, anxiety and depression mood was analyzed. Methods: From October 2019 to October 2020, 30 breast cancer patients admitted to the Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Anhui Province were selected. A total of 15 physical examination personnel in the Health Examination Center of our hospital during the same period were also selected. The self-rating anxiety scale and the self-rating depression scale were used to conduct questionnaire surveys and group patients into breast cancer with anxiety-depression group(BCAD group), breast cancer without anxietydepression group(BWCAD group), healthy people without anxiety-depression group(HWAD group). There were 15 patients in each group. The sequencing was performed on stool specimens from three groups. The sequencing results were analyzed based on the cluster analysis, diversity and structure analysis of operating unit classification(OTU), and the differences in the structure, abundance and diversity of the intestinal flora. At the same time, the correlation between intestinal flora and negative emotions such as anxiety-depression was analyzed. Results: For patients in the BCAD group, their anxiety scores were(58.80 ± 5.27), and depression scores were(59.60 ± 4.94). For patients in the BCAD group, their anxiety scores were(36.53 ± 4.52), and the depression scores were(38.20 ± 3.78). The anxiety scores and depression scores in the HWAD group were(35.13 ± 5.28) and(32.33 ± 4.37), respectively. There were significant differences among groups(P < 0.05). The diversity analysis of the intestinal flora showed that there were significant differences as for the Shannon index, Chao index, Ace index, Shannoneven index, and Coverage index among groups(P < 0.05). But there were no statistically significant differences as for the Simpson index(P > 0.05). The community difference analysis indicated that there were differences on the variety of phyla, class, order, family, and genera of intestinal flora among groups(P < 0.05). The main intestinal bacteria in the BCAD group were unclassifiedLachnospiracea, Sutterellaceae, Desulfovibrionales, and Escherichia-Shigella. The main intestinal bacteria in the BCWAD group were Lactobacillus and Flavonifractor. The Pearson analysis showed that Campylobacterales,Helicobacteraceae, Anaerolineaceae were significantly positively correlated with the levels of depression scores(P <0.05). However, there was no significant correlation between intestinal flora and the levels of anxiety scores(P > 0.05).Conclusion: The diversity and abundance of intestinal flora of breast cancer patients with anxiety and depression decreased, and there are some differences in the levels of phylaand genera. The main active flora was Unclassified-Lachnospiracea, Campylobacterales, and Helicobacteraceae, suggesting that the difference of intestinal flora structure may play a certain role in the occurrence of anxiety and depression in breast cancer patients.