肿瘤患者粪菌移植偏好调查及其肠道菌群组成特征分析

Investigation on the preference of fecal bacteria transplantation and analysis of the compositional characteristics of gut microbiota in tumor patients

目的探讨肿瘤患者对粪菌移植的偏好以及有无心理痛苦肿瘤患者肠道菌群的组成特征差异。方法选取四川大学华西医院收治的101位肿瘤患者,采用自行设计的问卷,调查其对粪菌移植的意愿、供体、途径的偏好,用Logistic回归推断与粪菌移植偏好相关的影响因素;并通过16S rRNA高通量测序技术分析其中11例肿瘤患者肠道菌群的组成特征。结果92例(91.1%)肿瘤患者愿意选择粪菌移植。Logistic回归分析结果表明,文化水平(P=0.001)和肿瘤分期(P=0.003)是影响肿瘤患者粪菌移植意愿的因素;老年患者更偏好陌生人作为供体(P=0.005),初中或以下文化程度的患者更愿意选择亲属作为粪菌移植的供体(P=0.007);女性(P=0.037)和ECOG体力状况评分较低(P=0.008)的患者更偏好以口服作为粪菌移植的途径。随机森林分析发现无心理痛苦组的肠道菌群中Flavonifractor菌、Akkermansia菌、Anaeroglobus菌、Lachnoclostridium菌、Tyzzerella-3菌的菌属丰度均较有心理痛苦组高,差异有统计学意义(P<0.05)。结论肿瘤患者对粪菌移植持积极态度,有心理痛苦与无心理痛苦的肿瘤患者的肠道菌群组成存在差异。

Objective To explore the preferences of tumor patients for fecal microbiota transplantation(FMT)and the differences in composition characteristics of gut microbiota in tumor patients with or without psychological distress.Methods One hundred and one tumor patients in our hospital were selected.Self-designed questionnaires were used to investigate their willingness,donors,and approach attitudes and preferences for FMT.Logistic regression was used to infer influencing factors related to FMT preferences.The 16S rRNA high-throughput sequencing technology was used to analyze the composition characteristics of the gut microbiota in 11 tumor patients.Results There were 92(91.1%)tumor patients willing to choose FMT.The logistic regression analysis showed that the educational level(P=0.001)and tumor stages(P=0.003)were the factors affecting the preference of FMT in tumor patients.Elderly patients preferred strangers as donors(P=0.005),patients with junior high school education or below were more willing to choose relatives as donors(P=0.007).Women(P=0.037)and patients with low ECOG PS scores(P=0.008)preferred oral administration as the route of FMT.Random forest analysis found that the abundance of Flavonifractor,Akkermansia,Anaeroglobus,Lachnoclostridium,and Tyzzerella-3 in the gut microbiota in the no-psychological distress group was higher than that in the psychological distress group(P<0.05).Conclusion Tumor patients have a positive attitude towards FMT.There are differences in the composition of gut microbiota of the tumor patients with and without psychological distress conditions.