结肠癌病人血清S100钙结合蛋白A12、可溶性晚期糖基化终产物受体水平与肠道菌群失调及化疗效果的关系

Correlation between serum S100A12 and sRAGE levels with intestinal flora imbalance and chemotherapy effect in patients with colon cancer

目的探讨结肠癌病人血清S100钙结合蛋白A12(S100A12)、可溶性晚期糖基化终产物受体(sRAGE)水平与肠道菌群失调及化疗效果的相关性。方法选择2020年12月至2021年12月黄河水利委员会黄河中心医院收治的116例中、晚期结肠癌病人作为结肠癌组,另选取在该院同期健康体检人员120例作为对照组。采用酶联免疫吸附测定(ELISA)检测血清S100A12、sRAGE水平,检测病人肠道菌群,并对病人化疗后进行随访,Pearson法分析结肠癌病人血清S100A12、sRAGE水平与菌群失调相关性,受试者操作特征曲线(ROC曲线)分析化疗前血清S100A12、sRAGE水平对结肠癌化疗效果的诊断价值。结果与对照组比较,结肠癌组病人化疗前血清S100A12、sRAGE水平显著升高(P<0.05)。与化疗前菌群正常组[(265.34±45.78)μg/L、(381.54±36.75)ng/L]比较,菌群失调Ⅰ度组[(301.52±56.95)μg/L、(440.63±48.71)ng/L]、菌群失调Ⅱ度组[(339.29±52.35)μg/L、(432.75±49.20)ng/L]病人血清S100A12、sRAGE水平显著升高(P<0.05);与菌群失调Ⅰ度组比较,菌群失调Ⅱ度组病人血清S100A12、sRAGE水平显著升高(P<0.05)。相关性分析显示,结肠癌病人血清S100A12、sRAGE水平与大肠杆菌、粪肠球菌数量呈正相关(P<0.05),与双歧杆菌、乳酸杆菌数量呈负相关(P<0.05)。与化疗前比较,结肠癌病人化疗后血清S100A12、sRAGE水平显著降低(P<0.05);与化疗缓解组[(272.33±55.36)μg/L、(403.24±40.54)ng/L]比较,化疗无效组[(330.09±42.64)μg/L、(482.85±43.61)ng/L]病人化疗前血清S100A12、sRAGE水平显著较高(P<0.05)。血清S100A12、sRAGE联合诊断结肠癌化疗无效的曲线下面积(AUC)为0.91[95%CI:(0.84,0.96),P<0.001],灵敏度为86.05%,特异度为80.82%。结论结肠癌病人血清S100A12、sRAGE升高,与肠道菌群失调及化疗效果有关,对化疗疗效评估与预后评价有一定指导意义。

Objective To investigate the correlation between serum levels of S100 calcium-binding protein A12(S100A12)and soluble receptor for advanced glycation end products(sRAGE)with intestinal flora imbalance and chemotherapy effect in patients with colon cancer.Methods A total of 116 patients with intermediate and advanced colon cancer admitted to Yellow River Central Hospital of Yellow River Water Conservancy Commission from December 2020 to December 2021 were selected as the colon cancer group.Another 120 healthy people who had undergone physical examination in our hospital were regarded as the control group.Serum S100A12 and sRAGE levels were detected by ELISA,the intestinal flora of patients was detected,and the patients were followed up after chemotherapy,Pearson method was used to analyze the correlation between serum S100A12 and sRAGE levels and intestinal flora imbalance in colon cancer patients,the diagnostic value of serum S100A12 and sRAGE levels before chemotherapy on the effect of colon cancer chemotherapy was analyzed by ROC curve.Results Compared with the control group,the serum levels of S100A12 and sRAGE in colon cancer group were significantly increased before chemotherapy(P<0.05).Compared with the normal group before chemotherapy[(265.34±45.78)μg/L,(381.54±36.75)ng/L],the serum levels of S100A12 and sRAGE in degreeⅠ[(301.52±56.95)μg/L,(440.63±48.71)ng/L]andⅡ[(339.29±52.35)μg/L,(432.75±49.20)ng/L]group were significantly increased(P<0.05).Compared with degreeⅠgroup,the serum levels of S100A12 and sRAGE in the degreeⅡgroup were significantly increased(P<0.05).Correlation analysis showed that serum S100A12 and sRAGE levels in colon cancer patients were positively correlated with the numbers of Escherichia coli and Enterococcus faecalis(P<0.05),and negatively correlated with the number of Bifidobacterium and Lactobacillus(P<0.05).Compared with those before chemotherapy,the serum S100A12 and sRAGE levels in colon cancer patients after chemotherapy were obviously decreased (P<0.05). Compared with the remission group [(272.33±55.36) μg/L, (403.24±40.54) ng/L], the levels of pre chemother-apy serum S100A12 and sRAGE in the chemotherapy-ineffective group [(330.09±42.64) μg/L, (482.85±43.61) ng/L] were obviously in-creased (P<0.05). The AUC of serum S100A12 combined sRAGE to diagnose the ineffectiveness of colon cancer chemotherapy was 0.91 [95%CI:(0.84,0.96),P<0.001], the sensitivity was 86.05%, and the specificity was 80.82%.Conclusion Serum S100A12 and sRAGE in patients with colon cancer are elevated, which are related to intestinal flora imbalance and chemotherapy effect, which has certain guiding significance for the evaluation of chemotherapy efficacy and prognosis.