Department of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
PLoS One. 2019 Jun 14;14(6):e0218436. doi: 10.1371/journal.pone.0218436. eCollection 2019.
Whether there are subsequent changes of metabolic profiles and microbiota status after partial colectomy remains unknown. We evaluated and compared long-term effects of microbiota status and metabolic profiles in early colorectal cancer (CRC) patients after curative colectomy to the controls. In this cross-sectional study, we analyzed metabolic syndrome occurrence in 165 patients after curative partial colectomy with right hemicolectomy (RH) or low anterior resection (LAR) and 333 age-sex matched controls. Fecal samples from some of those with RH, LAR, and controls were analyzed by next-generation sequencing method. The occurrences of metabolic syndrome were significantly higher in patients after RH, but not LAR, when compared with the controls over the long term (> 5 years) follow-up (P = 0.020). Compared with control group, RH group showed lower bacterial diversity (P = 0.007), whereas LAR group showed significantly higher bacterial diversity at the genera level (P = 0.016). Compared with the control group, the principal component analysis revealed significant differences in bacterial genera abundance after RH and LAR (P < 0.001). Furthermore, the Firmicutes to Bacteroidetes ratio was significantly lower in the RH group than the control group (22.0% versus 49.4%, P < 0.05). In conclusion, early CRC patients after RH but not LAR were associated with a higher occurrence of metabolic syndrome than the controls during long-term follow-up. In parallel with metabolic change, patients with RH showed dysbiosis with a tendency to decreased richness and a significant decrease in the diversity of gut microbiota.
右半结肠切除术(RH)或低位前切除术(LAR)后部分结肠切除的患者代谢谱和微生物群状态是否会发生后续变化尚不清楚。我们评估和比较了根治性结肠切除术后早期结直肠癌(CRC)患者与对照组的微生物群状态和代谢谱的长期影响。在这项横断面研究中,我们分析了 165 例 RH 和 LAR 根治性部分结肠切除术后患者和 333 例年龄性别匹配的对照组患者代谢综合征的发生情况。对部分 RH、LAR 和对照组患者的粪便样本进行了下一代测序分析。与长期(> 5 年)随访中的对照组相比,RH 组患者的代谢综合征发生率显著更高(P = 0.020)。与对照组相比,RH 组的细菌多样性较低(P = 0.007),而 LAR 组的细菌多样性在属水平显著较高(P = 0.016)。与对照组相比,主成分分析显示 RH 和 LAR 后细菌属丰度存在显著差异(P < 0.001)。此外,RH 组的厚壁菌门到拟杆菌门的比值显著低于对照组(22.0%比 49.4%,P < 0.05)。总之,与对照组相比,RH 组的早期 CRC 患者在长期随访中发生代谢综合征的几率高于对照组。与代谢变化平行,RH 患者表现出肠道微生物群落失调,丰富度降低,多样性显著减少。