Preoperative intestinal dysbacteriosis in colorectal cancer patients and its associated risk factors_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yuwei ¹ , XU Yujie ² ,  LI Ka ² , WANG Ziqiang ¹ , YANG Jie ¹ , JIANG Lili ¹

1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. College of Nursing, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LI Ka, Email: lika127@126.com

Keywords：

colorectal cancer; intestinal microecology; dysbacteriosis; risk factor

DOI：

10.7507/1007-9424.201905088

Video：

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Objective To investigate the prevalence of preoperative intestinal dysbacteriosis in colorectal cancer patients and its risk factors.Methods From March 2016 to December 2017, patients who received colorectal cancer surgery in the Department of Gastrointestinal Surgery in West China Hospital were prospectively recruited in the study. Fresh fecal samples were collected on the day of admission for gram-stainsmears. The diet, preexisted diseases, medication, and treatment before admission were investigated by a self-designed semi-structured questionnaire.Results Sum to 257 patients were recruited, 123 patients (47.9%) of them had normal intestinal bacterial, 48 patients (18.7%) were in preoperative dysbacteriosis grade Ⅰ, 61 patients (23.7%) were in gradeⅡ, 25 patients (9.7%) were in grade Ⅲ. Orderly logistic regression showed that patients who received antibiotics for 30 days or more per year had a higher risk of preoperative dysbacteriosis than those who did not receive antibiotics (OR=3.38, P=0.025). Patients with BMI≥24.0 kg/m² had a lower risk of dysbacteriosis than patients with BMI<18.5 kg/m² (BMI 24.0～27.9 kg/m², OR=0.36, P=0.030; BMI≥28.0 kg/m², OR=0.23, P=0.032).Conclusion More than half of colorectal cancer patients have intestinal dysbacteriosis prior to surgery, which may be associated with exposure to antibiotics before admission and low BMI.

Citation： LIU Yuwei, XU Yujie, LI Ka, WANG Ziqiang, YANG Jie, JIANG Lili. Preoperative intestinal dysbacteriosis in colorectal cancer patients and its associated risk factors. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1189-1195. doi: 10.7507/1007-9424.201905088 Copy

1.	康白. 正常微生物群是一個新的人體生理學系統. 中國微生態學雜志, 2003, 15(2): 4-6.
2.	中華預防醫學會微生態學分會. 中國消化道微生態調節劑臨床應用專家共識 (2016版). 中華臨床感染病雜志, 2016, 9(3): 193-206.
3.	Liu Z, Qin H, Yang Z, et al. Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery–a double-blind study. Aliment Pharmacol Ther, 2011, 33(1): 50-63.
4.	Vaishnavi C. Translocation of gut flora and its role in sepsis. Indian J Med Microbiol, 2013, 31(4): 334-342.
5.	Shogan BD, Belogortseva N, Luong PM, et al. Collagen degradation and MMP9 activation by Enterococcus faecalis contribute to intestinal anastomotic leak. Sci Transl Med, 2015, 7(286): 286ra68.
6.	Iida N, Dzutsev A, Stewart CA, et al. Commensal bacteria control cancer response to therapy by modulating the tumor microenvironment. Science, 2013, 342(6161): 967-970.
7.	張秀榮. 腸道菌群糞便涂片檢查圖譜. 北京: 人民軍醫出版社, 2000: 4-5.
8.	Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc, 2011, 43(8): 1575-1581.
9.	劉啟辰, 李丹, 曾小芳, 等. 重慶市居民體力活動、靜坐及睡眠時間對高血壓患病率的影響. 西安交通大學學報: 醫學版, 2019, 40(3): 474-479.
10.	曾忠銘, 潘令嘉, 周殿元, 等. 臨床微生態學及其理論基礎. 中國微生態學雜志, 1999, 11(6): 321-328.
11.	Velasquez-Manoff M. Gut microbiome: the peacekeepers. Nature, 2015, 518(7540): S3-S11.
12.	Guyton K, Alverdy JC. The gut microbiota and gastrointestinal surgery. Nat Rev Gastroenterol Hepatol, 2017, 14(1): 43-54.
13.	馬鵬程. 腸道菌群失調與結直腸癌上皮間充質轉化的相關性研究. 石家莊: 河北醫科大學, 2017.
14.	閆志輝, 崔立紅, 浦江, 等. 結直腸癌及腸道腺瘤性息肉患者腸道菌群失調情況及相關危險因素分析. 解放軍醫藥雜志, 2017, 29(5): 25-29.
15.	熊德鑫. 腸道微生態制劑與消化道疾病的防治. 北京: 科學出版社, 2008: 20-21.
16.	Ahn J, Sinha R, Pei Z, et al. Human gut microbiome and risk for colorectal cancer. J Natl Cancer Inst, 2013, 105(24): 1907-1911.
17.	郭世奎, 包維民, 龔昆梅, 等. SYBR GreenⅠ實時熒光定量PCR法分析結直腸癌患者腸道菌群變化. 中國普外基礎與臨床雜志, 2010, 17(5): 463-468.
18.	吳承堂, 譚建美. 大腸癌術后腸道菌群變化的臨床研究. 中華普通外科雜志, 2004, 19(6): 334-336.
19.	Rodríguez-Varón A, Mu?oz OM, Pulido-Arenas J, et al. Antibiotic-associated diarrhea: clinical characteristics and the presence of Clostridium difficile. Rev Gastroenterol Mex, 2017, 82(2): 129-133.
20.	Yoon MY, Yoon SS. Disruption of the gut ecosystem by antibiotics. Yonsei Med J, 2018, 59(1): 4-12.
21.	Tamma PD, Avdic E, Li DX, et al. Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med, 2017, 177(9): 1308-1315.
22.	Korpela K, Salonen A, Virta LJ, et al. Intestinal microbiome is related to lifetime antibiotic use in Finnish pre-school children. Nat Commun, 2016, 7: 10410.
23.	李文旋, 李小英, 寧麗娜, 等. 甘肅省老年人抗生素認知與自我用藥行為調查. 中國老年學雜志, 2015, 35(24): 7180-7182.
24.	張悅, 林嫻婷, 何貴蓉. 華東兩市城市與農村老年居民抗生素知識水平與自我用藥行為差異性分析. 護理研究, 2019, 33(4): 667-670.
25.	Wang H, Wang B, Zhao Q, et al. Antibiotic body burden of Chinese school children: a multisite biomonitoring-based study. Environ Sci Technol, 2015, 49(8): 5070-5079.
26.	de La Serre CB, Ellis CL, Lee J, et al. Propensity to high-fat diet-induced obesity in rats is associated with changes in the gut microbiota and gut inflammation. Am J Physiol Gastrointest Liver Physiol, 2010, 299(2): G440-G448.
27.	Van Immerseel F, Ducatelle R, De Vos M, et al. Butyric acid-producing anaerobic bacteria as a novel probiotic treatment approach for inflammatory bowel disease. J Med Microbiol, 2010, 59(Pt 2): 141-143.
28.	Stringer AM, Gibson RJ, Logan RM, et al. Gastrointestinal microflora and mucins may play a critical role in the development of 5-Fluorouracil-induced gastrointestinal mucositis. Exp Biol Med (Maywood), 2009, 234(4): 430-441.
29.	Shimizu K, Ogura H, Tomono K, et al. Patterns of Gram-stained fecal flora as a quick diagnostic marker in patients with severe SIRS. Dig Dis Sci, 2011, 56(6): 1782-1788.

1. 康白. 正常微生物群是一個新的人體生理學系統. 中國微生態學雜志, 2003, 15(2): 4-6.
2. 中華預防醫學會微生態學分會. 中國消化道微生態調節劑臨床應用專家共識 (2016版). 中華臨床感染病雜志, 2016, 9(3): 193-206.
3. Liu Z, Qin H, Yang Z, et al. Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery–a double-blind study. Aliment Pharmacol Ther, 2011, 33(1): 50-63.
4. Vaishnavi C. Translocation of gut flora and its role in sepsis. Indian J Med Microbiol, 2013, 31(4): 334-342.
5. Shogan BD, Belogortseva N, Luong PM, et al. Collagen degradation and MMP9 activation by Enterococcus faecalis contribute to intestinal anastomotic leak. Sci Transl Med, 2015, 7(286): 286ra68.
6. Iida N, Dzutsev A, Stewart CA, et al. Commensal bacteria control cancer response to therapy by modulating the tumor microenvironment. Science, 2013, 342(6161): 967-970.
7. 張秀榮. 腸道菌群糞便涂片檢查圖譜. 北京: 人民軍醫出版社, 2000: 4-5.
8. Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc, 2011, 43(8): 1575-1581.
9. 劉啟辰, 李丹, 曾小芳, 等. 重慶市居民體力活動、靜坐及睡眠時間對高血壓患病率的影響. 西安交通大學學報: 醫學版, 2019, 40(3): 474-479.
10. 曾忠銘, 潘令嘉, 周殿元, 等. 臨床微生態學及其理論基礎. 中國微生態學雜志, 1999, 11(6): 321-328.
11. Velasquez-Manoff M. Gut microbiome: the peacekeepers. Nature, 2015, 518(7540): S3-S11.
12. Guyton K, Alverdy JC. The gut microbiota and gastrointestinal surgery. Nat Rev Gastroenterol Hepatol, 2017, 14(1): 43-54.
13. 馬鵬程. 腸道菌群失調與結直腸癌上皮間充質轉化的相關性研究. 石家莊: 河北醫科大學, 2017.
14. 閆志輝, 崔立紅, 浦江, 等. 結直腸癌及腸道腺瘤性息肉患者腸道菌群失調情況及相關危險因素分析. 解放軍醫藥雜志, 2017, 29(5): 25-29.
15. 熊德鑫. 腸道微生態制劑與消化道疾病的防治. 北京: 科學出版社, 2008: 20-21.
16. Ahn J, Sinha R, Pei Z, et al. Human gut microbiome and risk for colorectal cancer. J Natl Cancer Inst, 2013, 105(24): 1907-1911.
17. 郭世奎, 包維民, 龔昆梅, 等. SYBR GreenⅠ實時熒光定量PCR法分析結直腸癌患者腸道菌群變化. 中國普外基礎與臨床雜志, 2010, 17(5): 463-468.
18. 吳承堂, 譚建美. 大腸癌術后腸道菌群變化的臨床研究. 中華普通外科雜志, 2004, 19(6): 334-336.
19. Rodríguez-Varón A, Mu?oz OM, Pulido-Arenas J, et al. Antibiotic-associated diarrhea: clinical characteristics and the presence of Clostridium difficile. Rev Gastroenterol Mex, 2017, 82(2): 129-133.
20. Yoon MY, Yoon SS. Disruption of the gut ecosystem by antibiotics. Yonsei Med J, 2018, 59(1): 4-12.
21. Tamma PD, Avdic E, Li DX, et al. Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med, 2017, 177(9): 1308-1315.
22. Korpela K, Salonen A, Virta LJ, et al. Intestinal microbiome is related to lifetime antibiotic use in Finnish pre-school children. Nat Commun, 2016, 7: 10410.
23. 李文旋, 李小英, 寧麗娜, 等. 甘肅省老年人抗生素認知與自我用藥行為調查. 中國老年學雜志, 2015, 35(24): 7180-7182.
24. 張悅, 林嫻婷, 何貴蓉. 華東兩市城市與農村老年居民抗生素知識水平與自我用藥行為差異性分析. 護理研究, 2019, 33(4): 667-670.
25. Wang H, Wang B, Zhao Q, et al. Antibiotic body burden of Chinese school children: a multisite biomonitoring-based study. Environ Sci Technol, 2015, 49(8): 5070-5079.
26. de La Serre CB, Ellis CL, Lee J, et al. Propensity to high-fat diet-induced obesity in rats is associated with changes in the gut microbiota and gut inflammation. Am J Physiol Gastrointest Liver Physiol, 2010, 299(2): G440-G448.
27. Van Immerseel F, Ducatelle R, De Vos M, et al. Butyric acid-producing anaerobic bacteria as a novel probiotic treatment approach for inflammatory bowel disease. J Med Microbiol, 2010, 59(Pt 2): 141-143.
28. Stringer AM, Gibson RJ, Logan RM, et al. Gastrointestinal microflora and mucins may play a critical role in the development of 5-Fluorouracil-induced gastrointestinal mucositis. Exp Biol Med (Maywood), 2009, 234(4): 430-441.
29. Shimizu K, Ogura H, Tomono K, et al. Patterns of Gram-stained fecal flora as a quick diagnostic marker in patients with severe SIRS. Dig Dis Sci, 2011, 56(6): 1782-1788.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Preoperative intestinal dysbacteriosis in colorectal cancer patients and its associated risk factors

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