摘要
目的观察原发性肝癌根治术联合经肝动脉化疗栓塞(TACE)术后患者肠道菌群的变化。方法选择2020年1月—2023年1月西安交通大学第二附属医院收治的114例原发性肝癌患者,对照组(57例)接受肝癌根治术,观察组(57例)在肝癌根治术后联合TACE治疗。比较两组临床疗效,检测血清指标及乳杆菌、肠杆菌、酵母菌、双歧杆菌等菌群数量,相关性采用Pearson相关系数分析。结果两组疾病控制率分别为94.74%、80.70%,观察组较高(P<0.05);治疗后观察组血清甲胎蛋白(AFP)、肿瘤坏死因子α(TNFα)、白细胞介素-6(IL-6)水平分别为(581.64±47.32)ng/mL、(85.13±15.37)pg/mL、(124.39±15.73)pg/mL,均明显低于对照组[分别为(662.37±52.49)ng/mL、(92.53±19.84)pg/mL、(145.81±19.77)pg/mL],白细胞介素-2(IL-2)水平为(86.22±5.84)pg/mL,明显高于对照组的(80.26±7.33)pg/mL(P<0.05)。治疗后观察组乳杆菌、双歧杆菌数量分别为(10.52±1.77)、(10.84±2.25)lgCFU/g,均明显高于对照组[分别为(8.34±1.63)、(9.52±1.37)lgCFU/g],治疗后观察组肠杆菌、酵母菌数量分别为(9.93±2.71)、(5.91±1.37)lgCFU/g,均明显低于对照组[分别为(13.95±3.82)、(7.83±1.58)lgCFU/g],P<0.05。血清AFP表达与乳杆菌、肠杆菌、酵母菌、双歧杆菌数量存在一定相关性(r=-0.522、0.498、0.503、-0.518,P=0.034、0.041、0.039、0.034),血清TNFα表达与肠道菌群数量存在一定相关性(r=-0.637、0.622、0.574、-0.592,P=0.005、0.005、0.021、0.018),血清IL-2表达与肠道菌群数量存在一定相关性(r=0.536、-0.508、-0.529、0.564,P=0.032、0.039、0.034、0.023),血清IL-6表达与肠道菌群数量存在一定相关性(r=-0.613、0.572、0.603、-0.517,P=0.006、0.021、0.007、0.034)。结论原发性肝癌根治术后TACE治疗有利于提高疾病控制率,促进肠道菌群平衡,降低炎症因子水平。
Objective To analyze the changes in intestinal flora in patients with primary liver cancer following radical resection combined with transcatheter arterial chemoembolization(TACE).Methods A total of 114 patients with primary liver cancer treated in our hospital from January 2020 to January 2023 were included in the study.The control group(57 cases)underwent radical liver cancer surgery,while the observation group(57 cases)received combined TACE treatment after radical liver cancer surgery.The clinical efficacy of the two groups was compared,and serum indices as well as the number of lactobacillus,enterobacter,yeast,bifidobacterium and other bacteria were measured.The correlation between these factors was analyzed by the Pearson correlation coefficient.Results The disease control rates in the observation group and the control group were 94.74%and 80.70%,respectively.The observation group had a significantly higher disease control rate compared to the control group(P<0.05).After treatment,the serum levels of alpha-fetoprotein(AFP),tumor necrosis factor-α(TNFα)and interleukin-6(IL-6)in the observation group were(581.64±47.32)ng/mL,(85.13±15.37)pg/mL,and(124.39±15.73)pg/mL,respectively,which were significantly lower than those of control group[(662.37±52.49)ng/mL,(92.53±19.84)pg/mL,(145.81±19.77)pg/mL,respectively].The levels of interleukin-2(IL-2)were(86.22±5.84)pg/mL,which was significantly higher than that in control group[(80.26±7.33)pg/mL,P<0.05].After treatment,the number of lactobacilli and bifidobacteria in the observation group were(10.52±1.77)lgCFU/g and(10.84±2.25)lgCFU/g,respectively,which were significantly higher than those in the control group[(8.34±1.63)lgCFU/g and(9.52±1.37)lgCFU/g,respectively].The number of Enterobacteriaceae and yeast in the observation group were(9.93±2.71)lgCFU/g and(5.91±1.37)lgCFU/g,respectively,which were significantly lower than those in the control group[(13.95±3.82)lgCFU/g and(7.83±1.58)lgCFU/g,P<0.05].Correlations were observed between serum AFP expression and the number of Lactobacillus,Enterobacter,yeast and bifidobacterium(r=-0.522,0.498,0.503,-0.518,P=0.034,0.041,0.039,0.034).Furthermore,the expression of TNFαin serum was correlated with the numbe of intestinal flora(r=-0.637,0.622,0.574,-0.592,P=0.005,0.005,0.021,0.018).The expression of serum IL-2 was also correlated with the number of intestinal flora(r=0.536,-0.508,-0.529,0.564,P=0.032,0.039,0.034,0.023).Similarly,the expression of serum IL-6 was correlated with the number of intestinal flora(r=-0.613,0.572,0.603,-0.517,P=0.006,0.021,0.007,0.034).Conclusion TACE treatment following radical surgery for primary liver cancer can improve the disease control rate,promote intestinal microbiota balance,and reduce inflammatory factor levels.
作者
任宏涛
王玉婷
尹佳锋
苏王辉
REN Hong-tao;WANG Yu-ting;YIN Jia-feng;SU Wang-hui(Department of Radiation Oncology,the Second Affiliated Hospital of Xi’an Jiaotong University,Shaanxi 710004,China;Radiotherapy Center,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Clinical Laboratory,the Second Affiliated Hospital of Xi’an Jiaotong University,Shaanxi 710004,China)
出处
《肝脏》
2023年第12期1450-1454,共5页
Chinese Hepatology
基金
陕西省自然科学基础研究计划(2022JQ-811)。
关键词
原发性肝癌
肝癌根治术
经肝动脉化疗栓塞
肠道菌群
Primary liver cancer
Radical resection of liver cancer
Transcatheter arterial chemoembolization
Intestinal microbiota
