摘要
目的探讨盆腔肿瘤患者同步放化疗对机体免疫功能、炎症状态和肠道微生态的影响。方法收集2021年7月-2022年12月青岛市中心医院收治的60例盆腔肿瘤患者同步放化疗前后的血液和粪便样本,采用流式细胞术检测外周血淋巴细胞亚群、细胞因子水平,采用实时荧光定量PCR方法(RT-qPCR)检测粪便中具核梭杆菌、双歧杆菌、嗜酸乳杆菌和链球菌的数量,比较各项指标同步放化疗前后的变化,并与疗效进行相关性分析。结果与治疗前相比,同步放化疗后盆腔肿瘤患者外周血CD3^(+)CD8^(+)细胞百分比、CD3-CD19^(+)细胞百分比、IL-10水平显著降低(t=2.571~2.995,P<0.05),CD3^(+)细胞百分比、CD3^(+)CD4^(+)细胞百分比、CD4^(+)/CD8^(+)比值及IL-1β、IL-2、IL-6、IFN-γ、TNF-α水平显著升高(t=-4.321~-2.638,P<0.05);粪便具核梭杆菌、双歧杆菌和嗜酸乳杆菌数量显著减少(t=3.128~3.954,P<0.05)。且治疗后外周血CD3^(+)细胞百分比、CD3^(+)CD4^(+)细胞百分比、粪便双歧杆菌、嗜酸乳杆菌数量与疗效呈正相关(r s=0.440~0.540,P<0.05)。外周血IL-6、TNF-α水平及粪便具核梭杆菌数量与疗效呈负相关(r_(s)=-0.685~-0.377,P<0.05)。结论盆腔同步放化疗可激活机体抗肿瘤免疫功能,促进炎症反应发生,导致肠道致病菌和益生菌减少,造成肠道菌群紊乱。盆腔同步放化疗后外周血CD3^(+)细胞百分比、CD4^(+)细胞百分比,IL-6、TNF-α水平,粪便双歧杆菌、嗜酸乳杆菌和具核梭杆菌数量与疗效密切相关。
Objective To investigate the effect of concurrent chemoradiotherapy on immune function,inflammatory state,and gut microbiota in patients with pelvic tumor.Methods Peripheral blood and stool samples were collected before and after concurrent chemoradiotherapy from 60 patients with pelvic tumor who were treated in Qingdao Central Hospital from July 2021 to December 2022.Flow cytometry was used to measure the levels of peripheral blood lymphocyte subsets and cytokines,and quantitative real-time PCR was used to measure the number of Fusobacterium nucleatum,Bifidobacterium,Lactobacillus acidophilus,and Streptococcus in stool.Each index was compared in terms of change before and after concurrent chemoradiotherapy,and their correlation with treatment outcome was analyzed.Results After concurrent chemoradiotherapy,the patients with pelvic tumor had significant reductions in the percentages of peripheral blood CD3^(+)CD8^(+)and CD3-CD19^(+)cells and the level of interleukin-10(t=2.571-2.995,P<0.05)and significant increases in the percentages of CD3^(+)and CD3^(+)CD4^(+)cells,CD4^(+)/CD8^(+)ratio,and the levels of interleukin-1β,interleukin-2,interleukin-6(IL-6),interferon gamma,and tumor necrosis factor-α(TNF-α)(t=-4.321--2.638,P<0.05),as well as significant reductions in the number of Fusobacterium nucleatum,Bifidobacte-rium,and Lactobacillus acidophilus(t=3.128-3.954,P<0.05).The percentages of CD3^(+)and CD3^(+)CD4^(+)cells and the number of Bifidobacterium and Lactobacillus acidophilus were positively correlated with treatment outcome(r s=0.440-0.540,P<0.05),while the levels of IL-6 and TNF-αand the number of Fusobacterium nucleatum were negatively correlated with treatment outcome(r s=-0.685--0.377,P<0.05).Conclusion Concurrent chemoradiotherapy for patients with pelvic tumor can activate the anti-tumor immune function of the body,promote inflammatory response,and lead to the reductions in intestinal pathogenic bacteria and probiotics,thereby causing gut microbiota disturbance.The percentages of CD3^(+)and CD4^(+)
作者
吕卓纯
陈晓慧
秦琛
鞠芳
LYU Zhuochun;CHEN Xiaohui;QIN Chen;JU Fang(Faculty of Medicine,Qingdao University,Qingdao 266071,China)
出处
《精准医学杂志》
2023年第2期149-153,共5页
Journal of Precision Medicine
基金
青岛市卫生科技计划项目(2018-WJZD055)。
关键词
盆腔肿瘤
宫颈肿瘤
直肠肿瘤
化放疗
细胞因子类
淋巴细胞亚群
胃肠道微生物组
治疗结果
Pelvic neoplasms
Uterine cervical neoplasms
Rectal neoplasms
Chemoradiotherapy
Cytokines
Lymphocyte subsets
Gastrointestinal microbiome
Treatment outcome
