口腔鳞癌患者治疗前后免疫功能和肠道菌群变化的临床分析

Clinical analysis of immune function and intestinal flora changes in patients with oral squamous carcinoma before and after treatment

目的:研究口腔鳞状细胞癌(OSCC)患者常规治疗前后肠道菌群和免疫功能变化情况。方法:选择2020年9月—2021年9月于安徽医科大学第一附属医院进行治疗的28例OSCC患者和10例健康志愿者为研究对象。OSCC患者经评估后给予治疗方案,记录患者治疗前1周和治疗6个月后临床症状、免疫功能和肠道菌群变化。采用GraphPad Prism 9.0软件包对数据进行统计学分析。结果:免疫功能检测结果发现,与健康志愿者相比,OSCC患者治疗前外周血中淋巴细胞亚群(包括CD3^(+)、CD4^(+)、NK、CD4^(+)/CD8^(+))和免疫球蛋白(包括IgG、IgA、IgM)水平明显偏低(P<0.05),血清细胞因子(包括TNF-α、IL-4、IL-6)水平偏高(P<0.05)。经6个月治疗后,OSCC患者免疫功能相较于治疗前有所提高(P<0.05),血清中促炎因子水平降低(P<0.05)。肠道菌群检测结果发现,与健康志愿者相比,OSCC患者治疗前肠道菌群多样性降低,治疗后,OSCC患者肠道菌群多样性有所恢复。菌群分布门水平上,与健康志愿者相比,OSCC患者治疗前肠道内Epsilonbacteraeota、Proteobacteria和Patescibacteria升高,Verrucomicrobia水平降低(P<0.05)。治疗降低了Epsilonbacteraeota、Proteobacteria和Patescibacteria水平,提高了Verrucomicrobia水平(P<0.05)。短链脂肪酸方面,与健康志愿者相比,OSCC患者治疗前肠道短链脂肪酸(包括乙酸、丙酸和丁酸)含量降低,治疗后,OSCC患者肠道短链脂肪酸含量升高。结论:常规治疗后能明显提高OSCC患者免疫功能,恢复患者肠道菌群分布,提高肠道短链脂肪酸含量,改善患者健康水平。

PURPOSE:To characterize the alterations of intestinal bacteria and immunological function in patients with oral squamous cell carcinoma(OSCC)before and after treatment.METHODS:From September 2020 to September 2021,28 patients suffering OSCC and 10 healthy volunteers undergoing treatment at our hospital were enrolled in the study.Conventional treatment regimens were administered to OSCC patients and the changes in immune function,intestinal bacteria composition and short-chain fatty acids were measured 1 week before and 6 months after therapy.GraphPad Prism 9.0 software package was used for data analysis.RESULTS:Immunological function measurements indicated significantly lower levels of lymphocyte subsets(including CD3^(+),CD4^(+),NK,CD4^(+)/CD8^(+))and immunoglobulins(including IgG,IgA,IgM)in the peripheral blood of OSCC patients before treatment compared to healthy volunteers(P<0.05),as well as remarkably lower levels of serum cytokines(including TNF-α、IL-4、IL-6)(P<0.05).Following 6 months of conventional treatment,there was an improvement in immune function in OSCC patients compared to all patients before treatment(P<0.05).Compared to healthy volunteers,the diversity of intestinal bacteria was decreased in OSCC patients before treatment,whereas the diversity of intestinal bacteria recovered in OSCC patients after conventional treatment.At the phylum,the distribution of Epsilonbacteraeota,Proteobacteria and Patescibacteria were significantly elevated and the concentration of Verrucomicrobia was decreased in OSCC patients before treatment compared to healthy volunteers(P<0.05).Intriguingly,convention therapy reversed the disturbance of intestinal bacteria,including downgrading levels of Epsilonbacteraeota,Proteobacteria and Patescibacteria and increasing levels of Verrucomicrobia(P<0.05).Short-chain fatty acids(including acetic acid,propionic acid and butyric acid)were present at a lower level in the intestine of OSCC patients before treatment and were elevated after conventional treatment.CONCLUSIONS:Conventional treatment remarkably enhances immune function,revitalizes the distribution of intestinal microflora,elevates the content of short-chain fatty acids in the intestine of OSCC patients,thereby improving the patients’health.