宫颈癌外照射对肠道菌群的影响

Effect of external irradiation on intestinal flora in patients with cervical cancer

目的研究外照射对宫颈癌患者肠道菌群的影响。方法收集宫颈癌患者67例外照射调强放射治疗前后粪便样本。利用Illumina NovaSeq高通量测序菌群,通过自身对照,将患者分为治疗前组(T0组)与治疗后组(T1组),分析肠道菌群的变化;再根据放射性肠炎程度分为无放射性肠炎组(E0组)及放射性肠炎组(E1组);根据肿瘤消退率分有效组(R1组)及效果欠佳组(R0组),分析患者肠道菌群变化。结果T0组和T1组肠道菌群的α多样性指数差异均无统计学意义(P>0.05);β多样性Bray-Curtis指数差异有统计学意义(P<0.05)。E0与E1组治疗前后α多样性指数、β多样性指数差异均无统计学意义(P>0.05),在菌群组成上,发现在外照射后E0组中放线菌目、微球菌科、罗氏菌属,E1组中乳杆菌科、拟杆菌门、拟杆菌目S24_7、Bulleidia增高;R0与R1组治疗前后α多样性指数、β多样性指数差异均无统计学意义(P>0.05);在R1组肠道中拟杆菌、毛螺菌科-Lactonifactor、巴斯德菌科、丹毒丝菌的相对丰度增高。结论宫颈癌患者外照射前后肠道菌群结构和组成均有显著改变,此变化可能与增加放射性肠炎的发生有关,并可能对近期治疗效果产生一定影响。

Objective To study the effect of external irradiation on intestinal flora in patients with cervical cancer.Methods Fecal samples of 72 patients with cervical cancer before and after external irradiation radiotherapy were collected.The changes of intestinal flora were analyzed by Illumina NovaSeq high-throughput sequencing plat form.Patients were divided into pre-treatment group(T0 group)and post-treatment group(T1 group)by self-control method.And then patients were divided into non-radiation enteritis group(E0 group)and radiation enteritis group(E1 group)according to the degree of radiation enteritis.According to the tumor regression rate,the patients were divided into effective group(R1 group)and ineffective group(R0 group).Then,data of the changes of intestinal flora were analyzed.Results There was no significant difference inαdiversity index in intestinal flora between T0 group and T1 group(P>0.05).There was no significant difference inαdiversity index andβdiversity index before and after treatment between E0 and E1 groups(P>0.05).In terms of microflora composition,it was found that Actinomycetales.Micrococaceae,and Rothia in E0 group,Lactobacillaceae,Bacteroidetes,Bacteroidales S24_7 and Bulleidia in E1 group increased after external irradiation.There was no significant difference inαdiversity index andβdiversity index between R0 and R1 groups(P>0.05).However,the relative abundance of Bacteroides,f-Lachnospiraceae.g-Lactonifator,Pasteurella and Erysipelotrichaceae increased in R1 group.Conclusion There are significant changes in the structure and composition of intestinal flora in patients with cervical cancer before and after external irradiation,which may be related to the increase of radiation enteritis and may affect the short-term therapeutic effect.