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[高原地区结直肠良恶性肿瘤患者肠道菌群变化及与低海拔地区正常人群的比较]

[Changes of intestinal microflora in patients with colorectal benign and malignant tumors in high altitude area and comparison with the normal population in low altitude area].

作者信息

Han D, Ciren Y, Li Q, Li J

机构信息

Department of Gastroenterology, Tibet University School of Medicine, People's Hospital of Tibet Autonomous Region, Lasa 850000, China.

Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Jun 18;57(3):578-583. doi: 10.19723/j.issn.1671-167X.2025.03.023.

Abstract

OBJECTIVE

To analyze the changes of intestinal flora in patients with benign and malignant colorectal tumors in high altitude areas and to compare them with the normal population in low altitude areas.

METHODS

The clinical data of 61 patients who underwent colonoscopy in the People' s Hospital of Tibet Autonomous Region from 2020 to 2022 were collected as the high altitude group. According to the colonoscopy results, they were divided into control group (29 cases), non-adenomatous polyp group (12 cases), adenoma group (10 cases), colorectal cancer group (10 cases). 17 patients who had negative colonoscopy results in the Peking University Third Hospital during the same period were collected as the low altitude control group. Before bowel preparation for colonoscopy, the fecal samples were collected. Then the DNA of bacteria in the fecal samples was extracted. The V3-V4 variable region of the 16S rRNA gene was PCR amplified and high-throughput sequenced. The species diversity of fecal flora was analyzed.

RESULTS

Alpha diversity analysis showed that the species diversity of samples from the high altitude colorectal cancer group differed statistically from that of the high altitude non-adenomatous polyp group and the low altitude control group, and the species diversity of colorectal samples from the high altitude colorectal cancer group was higher than that of the other two groups. While beta diversity showed no significant difference among the five groups. Differences were found in phylum level analysis that the abundance of Actinobacteriota in the low altitude control group was significantly lower than those in each group of the high altitude area, while the abundance of Actinobacteriota in the colorectal cancer group was significantly lower than those in the other 3 groups of the high altitude area. Differences were found in genus level analysis that the abundance of and in the low altitude control group was significantly higher than those of all the groups in the high altitude area; the abundance of and in the high altitude control group was the highest. was not detected in the low altitude control group, while there was a highly significant difference ( < 0.05) in the level of in the four groups of high altitude area, and the abundance of was significantly higher in the control group than those of the other three groups. In the four groups of samples at high altitude, the abundance of decreased significantly, while the abundance of Christensenellaceae_R-7_group increased significantly.

CONCLUSION

Compared with the high and low altitude controls, the diversity and abundance of intestinal flora in patients with colorectal benign and malignant tumors at high altitudes are different. And the abundance of species are also diffe-rent at the phylum and genus levels, suggesting that altitude factors may have some influence on intestinal flora.

摘要

目的

分析高海拔地区结直肠良恶性肿瘤患者肠道菌群的变化,并与低海拔地区正常人群进行比较。

方法

收集2020年至2022年在西藏自治区人民医院接受结肠镜检查的61例患者的临床资料作为高海拔组。根据结肠镜检查结果,将其分为对照组(29例)、非腺瘤性息肉组(12例)、腺瘤组(10例)、结直肠癌组(10例)。同期收集北京大学第三医院结肠镜检查结果为阴性的17例患者作为低海拔对照组。在结肠镜检查肠道准备前,采集粪便样本。然后提取粪便样本中细菌的DNA。对16S rRNA基因的V3-V4可变区进行PCR扩增和高通量测序。分析粪便菌群的物种多样性。

结果

α多样性分析显示,高海拔结直肠癌组样本的物种多样性与高海拔非腺瘤性息肉组和低海拔对照组在统计学上存在差异,高海拔结直肠癌组结直肠样本的物种多样性高于其他两组。而β多样性显示五组之间无显著差异。在门水平分析中发现,低海拔对照组放线菌门的丰度显著低于高海拔地区的各组,而结直肠癌组放线菌门的丰度显著低于高海拔地区的其他3组。在属水平分析中发现,低海拔对照组和 的丰度显著高于高海拔地区的所有组;高海拔对照组 和 的丰度最高。低海拔对照组未检测到 ,而高海拔地区四组 的水平存在高度显著差异(<0.05),对照组 的丰度显著高于其他三组。在高海拔地区的四组样本中, 的丰度显著降低,而克里斯滕森菌科_R-7_组的丰度显著增加。

结论

与高海拔和低海拔对照组相比,高海拔地区结直肠良恶性肿瘤患者肠道菌群的多样性和丰度存在差异。在门和属水平上物种丰度也不同,提示海拔因素可能对肠道菌群有一定影响。

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