口腔鳞癌患者治疗前后免疫功能和肠道菌群变化的临床分析

doi:10.19439/j.sjos.2022.05.014

上海口腔医学 ›› 2022, Vol. 31 ›› Issue (5): 523-529.doi: 10.19439/j.sjos.2022.05.014

口腔鳞癌患者治疗前后免疫功能和肠道菌群变化的临床分析

钱毅^1,2, 邓超³, 许晓波⁴, 陈叶俊⁵, 胡媛平^1,2, 洪礼琳^1,2, 冯大军^1,2

1.安徽医科大学第一附属医院口腔科,安徽合肥 230012;
2.安徽省公共卫生临床中心,安徽合肥 230012;
3.皖南医学院口腔医学院,安徽芜湖 241002;
4.合肥市口腔医院特需诊疗中心,安徽合肥 230022;
5.安徽医科大学附属口腔医院,安徽合肥 230022

收稿日期:2022-03-18 修回日期:2022-04-28 出版日期:2022-10-25 发布日期:2022-11-01
通讯作者: 陈叶俊,E-mail: 493121512@qq.com
作者简介:钱毅(1978-),男,硕士,副主任医师,E-mail: jacqian@126.com
基金资助:
安徽医科大学校研基金项目（临床科学基金）（2021xkj180）

Clinical analysis of immune function, intestinal flora changes in patients with oral squamous carcinoma before, after treatment

QIAN Yi^1,2, DENG Chao³, XU Xiao-bo⁴, CHEN Ye-jun⁵, HU Yun-ping^1,2, HONG Li-lin^1,2, FENG Da-jun^1,2

1. Department of Stomatology, The First Affiliated Hospital of Anhui Medical University. Hefei 230012;
2. Anhui Public Health Clinical Center. Hefei 230012;
3. College of Dentistry, Wannan Medical College. Wuhu 241002;
4. Hefei Dental Hospital Special Needs Treatment Center. Hefei 230022;
5. Anhui Medical University Dental Hospital. Hefei 230022, Anhui Province, China

Received:2022-03-18 Revised:2022-04-28 Online:2022-10-25 Published:2022-11-01

摘要/Abstract

摘要： 目的: 研究口腔鳞状细胞癌（OSCC）患者常规治疗前后肠道菌群和免疫功能变化情况。方法: 选择2020年9月—2021年9月于安徽医科大学第一附属医院进行治疗的28例OSCC患者和10例健康志愿者为研究对象。OSCC患者经评估后给予治疗方案,记录患者治疗前1周和治疗6个月后临床症状、免疫功能和肠道菌群变化。采用GraphPad Prism 9.0软件包对数据进行统计学分析。结果: 免疫功能检测结果发现,与健康志愿者相比,OSCC患者治疗前外周血中淋巴细胞亚群（包括CD3⁺、CD4⁺、NK、CD4⁺/CD8⁺）和免疫球蛋白（包括IgG、IgA、IgM）水平明显偏低（P<0.05）,血清细胞因子（包括TNF-α、IL-4、IL-6）水平偏高（P<0.05）。经6个月治疗后,OSCC患者免疫功能相较于治疗前有所提高（P<0.05）,血清中促炎因子水平降低（P<0.05）。肠道菌群检测结果发现,与健康志愿者相比,OSCC患者治疗前肠道菌群多样性降低,治疗后,OSCC患者肠道菌群多样性有所恢复。菌群分布门水平上,与健康志愿者相比,OSCC患者治疗前肠道内Epsilonbacteraeota、Proteobacteria和Patescibacteria升高,Verrucomicrobia水平降低（P<0.05）。治疗降低了Epsilonbacteraeota、Proteobacteria和Patescibacteria水平,提高了Verrucomicrobia水平（P<0.05）。短链脂肪酸方面,与健康志愿者相比,OSCC患者治疗前肠道短链脂肪酸（包括乙酸、丙酸和丁酸）含量降低,治疗后,OSCC患者肠道短链脂肪酸含量升高。结论: 常规治疗后能明显提高OSCC患者免疫功能,恢复患者肠道菌群分布,提高肠道短链脂肪酸含量,改善患者健康水平。

关键词: OSCC, 免疫功能, 肠道菌群, 短链脂肪酸

Abstract: PURPOSE: To characterize the alterations of intestinal bacteria and immunological function in patients with oral squamous cell carcinoma(OSCC) before and after treatment. METHODS: From September 2020 to September 2021, 28 patients suffering OSCC and 10 healthy volunteers undergoing treatment at our hospital were enrolled in the study. Conventional treatment regimens were administered to OSCC patients and the changes in immune function, intestinal bacteria composition and short-chain fatty acids were measured 1 week before and 6 months after therapy. GraphPad Prism 9.0 software package was used for data analysis. RESULTS: Immunological function measurements indicated significantly lower levels of lymphocyte subsets (including CD3⁺, CD4⁺, NK, CD4⁺/CD8⁺) and immunoglobulins (including IgG, IgA, IgM) in the peripheral blood of OSCC patients before treatment compared to healthy volunteers (P<0.05), as well as remarkably lower levels of serum cytokines (including TNF-α、IL-4、IL-6) (P<0.05). Following 6 months of conventional treatment, there was an improvement in immune function in OSCC patients compared to all patients before treatment(P<0.05). Compared to healthy volunteers, the diversity of intestinal bacteria was decreased in OSCC patients before treatment, whereas the diversity of intestinal bacteria recovered in OSCC patients after conventional treatment. At the phylum, the distribution of Epsilonbacteraeota, Proteobacteria and Patescibacteria were significantly elevated and the concentration of Verrucomicrobia was decreased in OSCC patients before treatment compared to healthy volunteers(P<0.05). Intriguingly, convention therapy reversed the disturbance of intestinal bacteria, including downgrading levels of Epsilonbacteraeota, Proteobacteria and Patescibacteria and increasing levels of Verrucomicrobia(P<0.05). Short-chain fatty acids (including acetic acid, propionic acid and butyric acid) were present at a lower level in the intestine of OSCC patients before treatment and were elevated after conventional treatment. CONCLUSIONS: Conventional treatment remarkably enhances immune function, revitalizes the distribution of intestinal microflora, elevates the content of short-chain fatty acids in the intestine of OSCC patients, thereby improving the patients' health.

Key words: Oral squamous cell carcinoma, Immunological function, Intestinal bacteria, Short-chain fatty acids

中图分类号:

R781.4

钱毅, 邓超, 许晓波, 陈叶俊, 胡媛平, 洪礼琳, 冯大军. 口腔鳞癌患者治疗前后免疫功能和肠道菌群变化的临床分析[J]. 上海口腔医学, 2022, 31(5): 523-529.

QIAN Yi, DENG Chao, XU Xiao-bo, CHEN Ye-jun, HU Yun-ping, HONG Li-lin, FENG Da-jun. Clinical analysis of immune function, intestinal flora changes in patients with oral squamous carcinoma before, after treatment[J]. Shanghai Journal of Stomatology, 2022, 31(5): 523-529.

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口腔鳞癌患者治疗前后免疫功能和肠道菌群变化的临床分析

Clinical analysis of immune function, intestinal flora changes in patients with oral squamous carcinoma before, after treatment

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