结肠癌根治术后肠道菌群及益生菌干预对结肠癌预后的影响

郭桂元; 黄子成; 林婵婵; 黄志鹏

doi:10.16016/j.1000-5404.201708195

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结肠癌根治术后肠道菌群及益生菌干预对结肠癌预后的影响

临床医学 | 更新时间：2026-01-09

- 结肠癌根治术后肠道菌群及益生菌干预对结肠癌预后的影响
- Effect of intestinal flora and probiotic intervention on prognosis in colon cancer patients after radical resection
- 第三军医大学学报 2017年39卷第23期页码：2293-2298
- 作者机构：
  
  362000 福建泉州, 福建省泉州市第一医院消化内科
- 作者简介：
  
  [郭桂元，E-mail: mgya555@163.com GUO Guiyuan, E-mail: mgya555@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201708195
  中图分类号： R181.32;R372;R735.35
- 收稿：2017-08-29，
  
  修回：2017-09-28，
  
  纸质出版：2017-12-15
- 稿件说明：
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郭桂元, 黄子成, 林婵婵, 等. 结肠癌根治术后肠道菌群及益生菌干预对结肠癌预后的影响[J]. 第三军医大学学报, 2017,39(23):2293-2298.

Guiyuan GUO, Zicheng HUANG, Chanchan LIN, et al. Effect of intestinal flora and probiotic intervention on prognosis in colon cancer patients after radical resection[J]. Journal of Third Military Medical University, 2017, 39(23): 2293-2298.
郭桂元, 黄子成, 林婵婵, 等. 结肠癌根治术后肠道菌群及益生菌干预对结肠癌预后的影响[J]. 第三军医大学学报, 2017,39(23):2293-2298. DOI： 10.16016/j.1000-5404.201708195.

Guiyuan GUO, Zicheng HUANG, Chanchan LIN, et al. Effect of intestinal flora and probiotic intervention on prognosis in colon cancer patients after radical resection[J]. Journal of Third Military Medical University, 2017, 39(23): 2293-2298. DOI： 10.16016/j.1000-5404.201708195.

摘要

目的

考察结肠癌根治术后肠道菌群与结肠癌预后的关系，以及益生菌干预对结肠癌预后的影响。

方法

收集2010年4月至2013年4月在我院收治并确诊的Ⅱ期结肠癌患者185例，患者均接受根治术，按照实际接受的治疗方案分为益生菌干预组(80例)和益生菌未干预组(105例)，选择同期健康体检者20例为对照组。收集术前和术后1个月粪便，采用荧光定量PCR检测粪便的乳酸杆菌属、双歧杆菌属、大肠杆菌和肠球菌属。分析结肠癌患者术后4年生存情况及与肠道菌群数量的关系。

结果

两组术前双歧杆菌属、乳酸杆菌属、大肠杆菌和肠球菌属差异无统计学意义(

0.05)，根治术后，双歧杆菌属、乳酸杆菌属、双歧杆菌属、大肠杆菌和肠球菌属均明显降低(

0.05)，益生菌干预组和益生菌未干预组的菌群术前、术后差异均无统计学意义(

0.05)。4年随访，无1例失访。105例益生菌未干预组中存活90例(85.71%)，15例(14.29%)死亡，其中14例为结肠癌转移死亡，1例为心血管病死亡。乳酸杆菌属(χ

=6.700

=0.035)和双歧杆菌属(χ

=5.777

=0.016)数量越高，大肠杆菌(χ

=3.301

=0.069)和肠球菌属(χ

=4.780

=0.029)数量越低，结肠癌患者4年生存时间越长。80例益生菌干预组中存活76例(95.00%)，4例(5.00%)患者死亡，其中3例为结肠癌转移死亡，1例交通意外死亡。与益生菌未干预组比较，益生菌干预组的存活例数较多(χ

=4.248

=0.039)，因结肠癌转移死亡例数较少(χ

=4.997

=0.025)。

结论

结肠癌根治术后，双歧杆菌属和乳酸杆菌属数量越高，大肠杆菌和肠球菌属数量越低，结肠癌的预后较好。给予益生菌干预可明显改善结肠癌根治术后患者的生存情况。

Abstract

Objective

To investigate the relationship between intestinal flora and prognosis after radical resection for colon cancer

and determine the effect of probiotic intervention on the prognosis.

Methods

A total of 185 patients with identified stage Ⅱ colon cancer before radical rese

ction admitted to our hospital from April 2010 to April 2013 were enrolled in the study. They were randomly divided into probiotic intervention group (

=80) and non-probiotic intervention group (

=105). Another 20 healthy subjects who took physical examination at the same period served as the control group. Fluorescence quantitative PCR was used to detected

Bifidobacterium

Lactobacillus

Escherichia coli

and

Enterococcus

in stool samples before and in 1 month after operation. The relationship between the 4-year survival and the types and amounts of intestinal flora was analyzed.

Results

There were no significant differences in the amounts of

Bifidobacterium

Lactobacillus

Escherichia coli

and

Enterococcus

in the colon cancer patients before operation when compared with the control group (

0.05). After radical resection

the amounts of

Bifidobacterium

Lactobacillus

Bifidobacterium

Escherichia coli

and

Enterococcus

were significantly decreased (

0.05). Probiotic intervention had no effect on the types and amounts of intestinal flora in the patients no matter before or after surgery (

0.05). No one lost during the 4 years' follow-up. In the 105 cases receiving non-probiotic intervention

90 patients (85.71%) were survived and 15 (14.29%) died

including 14 cases due to colorectal cancer metastasis and 1 to cardiovascular disease. The higher amounts of

E.coli

(

Chi

-square=6.700

=0.035) and

Bifidobacterium

(

Chi

-square=5.777

=0.016)

and the lower amounts of

Escherichia coli

(

Chi

-square=3.301

=0.069) and

Enterococcus

(

Chi

-square=4.780

=0.029)

the survival time was longer in the follow-up. In the 80 cases receiving probiotic intervention

76 cases (95.00%) survived and 4 (5.00%) died. Three of them died of colorectal cancer metastasis and 1 case died of traffic accident. The probiotic group had larger survival cases (

Chi

-square=4.248

=0.039) and less died of metastasis (

Chi

-square=4.997

=0.025) than the non-probiotic intervention group.

Conclusions

The higher amounts of

E.coli

and

Bifidobacterium

and the lower amounts of

Escherichia coli

and

Enterococcus

indicate better prognosis in the colon cancer patients after radical resection. Probiotic intervention can significantly improve the survival in the patients.

关键词

Keywords

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