胃癌患者化疗前后口腔菌群与肠道菌群变化特征

Changes of oral and intestinal flora in patients with gastric cancer before and after chemotherapy

目的研究胃癌患者化疗前后口腔菌群与肠道菌群的变化特征,为该类患者的治疗提供参考。方法选取2017年2月至2020年2月于我院接受治疗的96例胃癌患者为观察组,另外选取同期我院健康体检者90例为对照组,收集两组对象唾液样本和粪便样本,其中观察组患者需收集化疗前及化疗后两个时间点的样本。采用16S rRNA基因高通量测序法检测菌群构成,分析两组对象组间及观察组患者化疗前后口腔菌群与肠道菌群变化特征。结果化疗前,观察组患者唾液样本、粪便样本菌群Simpson指数、Shannon指数、厚壁菌门、拟杆菌门丰富度与对照组比较差异均无统计学意义(均P>0.05)。化疗前,观察组患者唾液样本及粪便样本中放线菌门丰富度显著高于对照组,变形菌门丰富度显著低于对照组(均P<0.05)。化疗后,观察组患者唾液样本中厚壁菌门、放线菌门、变形菌门丰富度较化疗前显著下降,拟杆菌门丰富度显著上升(均P<0.05);同时粪便样本中厚壁菌门、变形菌门丰富度较化疗前显著上升,拟杆菌门、放线菌门丰富度显著下降(均P<0.05)。化疗后,观察组患者唾液样本中韦荣球菌属、罗氏菌属、普氏菌属丰富度较化疗前显著增加,放线菌属、链球菌属、奈瑟菌属、粪梭杆菌属丰度显著下降(均P<0.05);同时粪便样本中链球菌属、肠志贺菌属、乳杆菌属丰富度较化疗前显著增加,粪梭杆菌属、双歧杆菌属、拟杆菌属丰富度显著下降(均P<0.05)。结论化疗对胃癌患者口腔菌群及肠道菌群构成有一定程度影响,患者口腔菌群中韦荣球菌属丰度上升,而肠道中正常菌群的生长受抑制。

Objective To explore the changes of oral and intestinal flora in patients with gastric cancer before and after chemotherapy, to provide reference for the treatment of this kind of patients. Methods A total of 96 gastric cancer patients(observation group) and 90 healthy individuals(control group) in our hospital from February 2017 to February 2020 were enrolled. Saliva samples and fecal samples were collected. The composition of bacterial flora was detected with 16 S rRNA high-throughput sequencing. The changes of oral and intestinal flora were analyzed between the two groups and before and after chemotherapy. Results Before chemotherapy, the Simpson index, Shannon index, abundances of Firmicutes and Bacteroidetes in saliva samples and fecal samples showed no significant differences between two groups(P>0.05). Before chemotherapy, in observation group, the abundance of Actinobacteria was higher, while that of Proteobacteria was lower than in control group respectively(P<0.05). After chemotherapy, in observation group, the abundances of Firmicutes, Actinobacteria and Proteobacteria significantly decreased, and that of Bacteroidetes significant increased in saliva samples(all P<0.05);in fecal samples, the abundances of Firmicutes and Proteobacteria significantly increased, and those of Bacteroidetes and Actinobacteria significantly decreased(all P<0.05). After chemotherapy, in observation group, the abundances of Veillonella, Rothia and Prevotella significantly increased in saliva samples, while those of Actinomyces, Streptococcus, Neisseria and Fusobacterium significantly decreased(all P<0.05). In fecal samples, the abundances of Streptococcus, Shigella and Lactobacillus significantly increased, while those of Fusobacterium, Bifidobacterium and Bacteroides significantly decreased(all P<0.05). Conclusion Chemotherapy has an effect on the compositions of oral and intestinal flora in gastric cancer patients, which increases the abundance of Veillonella in oral flora and inhibits the growth of normal bacteria in the intestinal tract.