摘要
目的分析粒细胞集落刺激因子(G-CSF)在结直肠癌患者血清中的表达及与肠道菌群失调、临床特征的关系。方法选择2022年1-8月陕西省宝鸡市中心医院收治的结直肠癌患者85例为观察组,选择同期健康人群85例为对照组,采集两组受检者粪便标本进行细菌培养,统计益生菌、有害菌菌落水平,比较两组受检者菌群失调情况。采集两组受检者空腹静脉血,采用酶联免疫吸附试验检测血清G-CSF水平。收集观察组患者临床病理资料,分析G-CSF水平与临床病理特征的关系。采用Pearson相关分析G-CSF水平与肠道菌群的相关性。结果观察组无菌群失调比例为16.47%,明显低于对照组的68.24%(P<0.05),观察组菌群失调Ⅱ度比例为54.12%,明显高于对照组的7.06%(P<0.05)。观察组双歧杆菌、乳酸杆菌、拟杆菌菌落水平明显低于对照组(P<0.05),大肠埃希菌、粪肠球菌、具核梭杆菌菌落水平明显高于对照组(P<0.05)。观察组G-CSF水平明显高于对照组(P<0.05)。肿瘤最大径≥5 cm、肿瘤部位为直肠、有远处转移、TNM分期Ⅲ+Ⅳ期、低分化患者G-CSF水平明显高于肿瘤最大径<5 cm、肿瘤部位为结肠、无远处转移、TNM分期Ⅰ+Ⅱ期、中高分化患者(P<0.05)。血清G-CSF水平与患者双歧杆菌、乳酸杆菌、拟杆菌菌群水平均呈明显负相关(r=-0.665、-0.616、-0.674,P<0.001);血清G-CSF水平与患者大肠埃希菌、粪肠球菌、具核梭杆菌菌群水平均呈明显正相关(r=0.736、0.741、0.774,P<0.001)。结论结直肠癌患者存在肠道菌群失调情况,维持肠道菌群平衡有助于降低结直肠癌发病风险。结直肠癌患者血清G-CSF水平异常表达,G-CSF水平与结直肠癌肠道菌群及临床病理特征密切相关,G-CSF有可能成为诊断结直肠癌及评估病情变化的血清学指标。
Objective To analyze the expression of granulocyte colony-stimulating factor(G-CSF)in the serum of the patients with colorectal cancer and its relationship with intestinal flora dysbiosis and clinical features.Methods Eighty-five patients with colorectal cancer admitted and treated in Baoji Municipal Central Hospital from January 2022 to August 2022 were selected as the observation group,and 85 healthy people during the same period were selected as the control group.The fecal samples were collected from the subjects in the two groups,and the bacterial culture was performed to count the level of probiotics and harmful bacteria colonies.The dysbiosis was compared between the two groups.The fasting venous blood of the two groups was collected,and the serum G-CSF level was detected by enzyme-linked immunosorbent assay,and the clinicopathological data of the observation group were collected.Then the relationship between the G-CSF level and clinicopathological features was analyzed.The Pearson correlation was adopted to analyze the correlation between G-CSF level with intestinal flora.Results The proportion of no bacterial dysbiosis in the observation group was 16.47%,which was significantly lower than 68.24%in the control group(P<0.05),and the proportion of bacterial dysbiosis Ⅱ in the observation group was 54.12%,which was significantly higher than 7.06% in the control group(P<0.05).The levels of Bifidobacterium,Lactobacillus and Bacteroides colonies in the observation group were significantly lower than those in the control group(P<0.05),and the levels of Escherichia coli,Enterococcus faecalis and Clostridium perfringens colonies were significantly higher than those in the control group(P<0.05).The level of G-CSF in the observation group was significantly higher than that in the control group(P<0.05).The G-CSF levels of the patients with tumor diameter≥5 cm,tumor site rectum,distant metastasis,TNM stage Ⅲ+Ⅳ and low differentiation were significantly higher than those of the patients with tumor diameter<5 cm,tumor site colon,no distant metastasis,TNM stage Ⅰ+Ⅱ and medium to high differentiation(P<0.05).Serum G-CSF level had significantly negative correlation with bifidobacteria,lactobacilli and bacteroid(r=-0.665,-0.616,-0.674,P<0.001);serum G-CSF level had significantly positive correlation with Escherichia coli,Enterococcus faecalis and Fusobacterium nucleatum(r=0.736,0.741,0.774,P<0.001).Conclusion The intestinal flora dysbiosis exists in the patients with colorectal cancer.Maintaining the balance of intestinal flora helps to reduce the onset risk of colorectal cancer.The level of serum G-CSF in the patients with colorectal cancer is expressed abnormally.The G-CSF level is correlated closely to the intestinal flora and clinicopathology of colorectal cancer.G-CSF may become a serological indicator for diagnosing colorectal cancer and evaluating the disease changes.
作者
梁哲
李康
LIANG Zhe;LI Kang(Department of Emergency,Baoji Municipal Central Hospital,Baoji,Shaanxi 721000,China;Department of Oncology,Baoji Municipal Central Hospital,Baoji,Shaanxi 721000,China)
出处
《检验医学与临床》
CAS
2023年第19期2834-2837,2842,共5页
Laboratory Medicine and Clinic
关键词
结直肠癌
肠道菌群结构
粒细胞集落刺激因子
临床病理学
colorectal cancer
intestinal flora structure
granulocyte colony stimulating factor
clinicopathology
