Søby J H, Watt S K, Vogelsang R P, Servant F, Lelouvier B, Raskov H, Knop F K, Gögenur I
Department of Surgery, Centre for Surgical Science, Zealand University Hospital, University of Copenhagen, Køge, Denmark.
The Danish Cancer Society, Copenhagen, Denmark.
BJS Open. 2020 Oct 6;4(6):1227-37. doi: 10.1002/bjs5.50357.
Mechanisms contributing to the perioperative stress response remain poorly understood. This study investigated changes in the amount of bacterial DNA in blood and the diversity of blood microbiota in the perioperative period in patients undergoing minimally invasive surgery for colonic cancer in an enhanced recovery after surgery setting.
DNA encoding the bacterial 16S ribosomal RNA gene (16S rDNA) in whole blood obtained the day before surgery, and on postoperative day (POD) 1 and POD 10-14 was amplified and quantified by PCR before sequencing for taxonomic assignment. Richness, evenness and similarity measures were calculated to compare microbiota between days. Differences in relative abundance were analysed using the linear discriminant analysis effect size (LEfSe) algorithm.
Thirty patients were included between January and July 2016. The concentration of bacterial 16S rDNA in blood increased between the day before surgery and POD 1 (P = 0.025). Bacterial richness was lower on POD 10-14 than on the day before surgery and POD 1 (both P < 0·001). LEfSe analysis comparing the day before surgery and POD 10-14 identified changes in the abundance of several bacteria, including Fusobacterium nucleatum, which was relatively enriched on POD 10-14.
These findings suggest that the blood of patients with colonic cancer harbours bacterial 16S rDNA, which increases in concentration after surgery.
围手术期应激反应的机制仍未得到充分理解。本研究调查了在术后加速康复环境下接受结肠癌微创手术的患者围手术期血液中细菌DNA数量的变化以及血液微生物群的多样性。
对手术前一天、术后第1天以及术后第10 - 14天采集的全血中编码细菌16S核糖体RNA基因（16S rDNA）的DNA进行PCR扩增和定量，然后进行测序以进行分类鉴定。计算丰富度、均匀度和相似度指标以比较不同时间点的微生物群。使用线性判别分析效应大小（LEfSe）算法分析相对丰度的差异。
2016年1月至7月纳入了30例患者。血液中细菌16S rDNA的浓度在手术前一天至术后第1天之间有所增加（P = 0.025）。术后第10 - 14天的细菌丰富度低于手术前一天和术后第1天（P均<0.001）。比较手术前一天和术后第10 - 14天的LEfSe分析确定了几种细菌丰度的变化，包括具核梭杆菌，其在术后第10 - 14天相对富集。
这些发现表明结肠癌患者的血液中含有细菌16S rDNA，其浓度在手术后会增加。
