结肠癌患者血清suPAR和GRP78水平与肠道菌群失调的相关性研究

Levels of serum suPAR and GRP78 in patients with colon cancer and their correlation with intestinal flora dysbiosis

目的探讨可溶性尿激酶型纤溶酶原激活物受体(suPAR)和葡萄糖调节蛋白78(GRP78)在结肠癌患者血清中的表达及其与肠道菌群失调的相关性。方法选取我院2020年5月至2023年5月接收的116例结肠癌患者作为结肠癌组,另选同期健康体检者114例作为对照组,采用ELISA法检测两组血清suPAR和GRP78水平。采集两组新鲜粪便进行革兰氏染色,根据镜下菌群数量将疾病组分为菌群正常组(n=41)、菌群失调Ⅰ度组(n=30)、菌群失调Ⅱ度组(n=24)、菌群失调Ⅲ度组(n=21)。比较各组血清suPAR、GRP78水平和肠球菌、双歧杆菌、乳杆菌数量,分析血清suPAR、GRP78水平与肠道菌群的相关性。结果结肠癌组血清suPAR和GRP78水平明显高于对照组(P<0.001),患者肠道失调情况越严重,血清suPAR、GRP78水平越高(P<0.001);结肠癌组肠球菌数量较对照组多,双歧杆菌和乳杆菌数量较对照组少(P<0.001),患者肠道失调情况越严重,双歧杆菌和乳杆菌数量越少,肠球菌数量越多(P<0.001);Pearson相关性分析显示,血清suPAR(r=0.830,P<0.001)、GRP78(r=0.766,P<0.001)水平与肠球菌数量呈正相关,与双歧杆菌(r=−0.799,P<0.001;r=−0.780,P<0.001)、乳杆菌(r=−0.792,P<0.001;r=−0.712,P<0.001)数量呈负相关。结论结肠癌患者血清suPAR和GRP78水平增加,可能与肠道菌群和其失调程度有关。

Objective To observe the levels of soluble urokinase plasminogen activator receptor(suPAR)and glucose regulated protein 78(GRP78)in sera of patients with colon cancer(CC)and their correlation with intestinal flora dysbiosis.Methods A total of 116 patients with CC in our hospital from May 2020 to May 2023 were selected as the CC group,with 114 healthy subjects in the same period selected as the control group.Serum levels of suPAR and GRP78 were detected with ELISA;fresh stool was collected,and intestinal flora was measured.According to the distribution of intestinal flora,the CC groups were divided into normal flora group(n=41),dysfunctional flora groupⅠ(n=30),dysfunctional flora groupⅡ(n=24)and dysfunctional flora groupⅢ(n=21).Serum levels of suPAR and GRP78 and the counts of enterococcus,bifidobacterium and lactobacillus were compared among the four groups,and the correlation of serum levels of suPAR and GRP78 levels with intestinal flora was evaluated.Results The serum levels of suPAR and GRP78 in the CC group were significantly higher than those in the control group(P<0.001);the more severe the intestinal disorder was,the higher the serum levels of suPAR and GRP78 were(P<0.001).The count of enterococcus in the CC group was more(P<0.001),while those of bifidobacterium and lactobacillus were less than those in the control group,respectively(P<0.001);the more severe the intestinal disorder was,the less the counts of bifidobacterium and lactobacillus and the more that of enterococcus were(P<0.001).Pearson correlation analysis showed that the levels of suPAR(r=0.830,P<0.001)and GRP78(r=0.766,P<0.001)were positively correlated with the count of enterococcus,and negatively correlated with those of bifidobacterium(r=−0.799,P<0.001;r=−0.780,P<0.001)and lactobacillus(r=−0.792,P<0.001;r=−0.712,P<0.001).Conclusion The serum suPAR and GRP78 increased in patients with colon cancer,which may be related to the intestinal flora and dysbiosis.