Role of Traditional Chinese Medicine Syndrome Type, Gut Microbiome, and Host Immunity in Predicting Early and Advanced Stage Colorectal Cancer.
Role of Traditional Chinese Medicine Syndrome Type, Gut Microbiome, and Host Immunity in Predicting Early and Advanced Stage Colorectal Cancer.
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DOI：
10.1177/15347354221144051
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发表时间：
2023-01
影响因子：
2.9
通讯作者：
Sun, Lingyun
中科院分区：
文献类型：
--
作者：
Yan, Yunzi;Yang, Yufei;Ning, Chunhui;Wu, Na;Yan, Shaohua;Sun, Lingyun
关键词：
探讨中医辨证分型、肠道菌群分布和宿主免疫功能在预测结直肠癌(CRC)早期和晚期临床分期中的作用。采用横断面病例对照研究，纳入2018年3月至2020年12月入选的48例早期结直肠癌患者和48例晚期结直肠癌患者。用16S rRNA基因测序分析患者肠道微生物区系，用流式细胞仪检测外周血中T、B淋巴细胞亚群。采用脾虚证(SDS)量表评定中医证型。进展期组肠道微生物区系中普氏杆菌、志贺氏菌和杆菌的丰度显著增加，类杆菌显著减少。只有早中期组才能检测到弧形相杆菌，而泽泻属只在晚期组才能检测到。早中期组淋巴细胞(P = .006)、辅助性T细胞(TH)(P = .002)、细胞毒性T细胞(TC)(P = .003)、双阳性T细胞(DPT)(P = .02)和T细胞总数(P = .001)均显著高于晚期中期组。与早期结直肠癌患者相比，进展期结直肠癌患者的抑郁自评量表评分较高。在调整临床分期后，Spearman相关分析显示肠道微生物丰度、T细胞水平和抑郁自评量表评分之间存在交互作用。多因素Logistic回归分析显示，在控制了抑郁评分、泽泻杆菌和革兰氏杆菌、双阴性T细胞(DNT)水平后，DPT显著降低了晚期疾病的风险(危险比，0.918；P = .022)。我们的研究提示了临床分期、SDS、肠道微生物区系和T淋巴细胞之间的关系，这为建立一个潜在的预测结直肠癌疾病进展的模型提供了见解。
To investigate the role of Traditional Chinese Medicine (TCM) syndrome type, gut microbiome distribution, and host immunity function in predicting the early and advanced clinical stages of colorectal cancer (CRC). A cross-sectional case-control study was performed which included 48 early stage and 48 advanced patients with CRC enrolled from March 2018 to December 2020. 16S rRNA gene sequencing was performed to analyze the gut microbiomes of the patients, while T and B lymphocyte subsets in peripheral blood were assessed using flow cytometry. TCM syndrome type was measured using the spleen deficiency syndrome (SDS) scale. The abundance levels of Prevotella, Escherichia-Shigella, and Faecalibacterium in the gut microbiota were significantly increased in the advanced group, while Bacteroides was significantly decreased. Phascolarctobacterium was detectable only in the early metaphase group, whereas Alistipes was detectable only in the advanced group. The lymphocyte (P = .006), T helper cell (TH) (P = .002), cytotoxic T cell (TC) (P = .003), double positive T cell (DPT) (P = .02), and total T counts (P = .001) were significantly higher in the early metaphase group than in the advanced metaphase group. Compared with patients with early stage CRC, the advanced group had a higher SDS score. After adjusting for clinical stage, Spearman’s correlation analysis showed interactions among gut microbiome abundance, T cell level, and SDS score. Multivariate logistic analysis showed that after controlling for the SDS score, abundance of Alistipes and Faecalibacterium, and double negative T cell (DNT) level, DPT was significantly associated with a lower risk of advanced-stage disease (hazard ratio, 0.918; P = .022). Our study suggested associations between clinical stage, SDS, gut microbiota, and T lymphocytes, which provided insights for a potential prediction model for the disease progression of CRC.
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