头颈部放疗对口腔菌群的影响

Effect of head and neck radiotherapy on oral microflora

目的:探究头颈部放疗的肿瘤患者随着放疗剂量的累积口腔菌群的变化及不同程度的放疗相关性口腔黏膜炎、口腔菌群的变化。方法:选取2019年11月至2020年4月在某医院放疗科接受头颈部放射治疗的患者20名,放射剂量为6996 cGy,均行动态调强放射治疗。在患者放疗累积剂量为0~19 Gy、20~39 Gy、40 Gy时,采集患者口腔唾液,颊黏膜咽拭子。利用lllumina测序技术检测微生物群落的组成与多样性。结果:在唾液菌群中,厚壁菌门、变形菌门随放疗剂量的累积相对丰度升高,奇古菌门、广古菌门、泉古菌门等随着放疗剂量的累积相对丰度明显降低;在颊黏膜中厚壁菌门、拟杆菌门、梭杆菌门相对丰度随黏膜炎程度加重而降低,放线菌门相对丰度随黏膜炎程度加重而升高;唾液菌群中厚壁菌门、放线菌门相对丰度与黏膜炎严重程度呈正相关,其他高丰度菌门与黏膜炎严重程度呈负相关。结论:放疗累积剂量增加肿瘤患者RIOM分级逐渐提高,口腔唾液菌群相对丰度改变,α多样性降低;黏膜炎程度加重,颊黏膜菌群与唾液菌群菌群相对丰度发生较大变化,α多样性降低。

Objective:This study aims to explore the variation of oral microflora in patients with head and neck cancer undergoing radiotherapy,and the association between the changes of oral microflora with the different degrees of radiation-induced oral mucositis.Methods:Twenty patients with head and neck cancer who received radiotherapy from November 2019 to April 2020 in one hospital were selected.Eligible patients received the dynamic intensity-modulated radiotherapy with the radiation dose of 6996 cGy.Oral saliva,buccal mucosa,and pharyngeal swabs were collected at 0~19 Gy,20~39 Gy,and 40 Gy of the cumulative dose of radiotherapy.The lllumina sequencing technology was performed to detect the composition and diversity of microbial communities.Results:In the salivary flora,the relative abundance of Firmicutes and Proteobacteria increased with the accumulation of radiation dose.The relative abundance of Thaumarchaeota,Euryarchaeota,Crenarchaeotadecreased significantly with the increase of radiation dose.The relative abundance of Firmicutes,Bacteroidetes,and Fusobacteria in buccinal mucosa decreased with the degree of mucositis increasing,while the relative abundance of Actinobacteria increased with the degree of mucositis increasing.The relative abundance of Firmicutes and Actinomycetes in the salivary flora was positively correlated with the severity of mucositis,while the relative abundance of other high-abundance flora was negatively correlated with the severity of mucositis.Conclusion:As the cumulative dose of radiotherapy increases,the RIOM classification of tumor patients gradually increases,the relative abundance of oral salivary flora changes,and the alpha diversity decreases.The degree of mucositis aggravate,the relative abundance of buccal mucosa and salivary flora change greatly,and alpha diversity decreases.