血清G-CSF、ADPN在奥沙利铂联合卡培他滨治疗Ⅲ期结直肠癌患者术后辅助中的表达及其与肠道菌群失调的相关性

摘要 目的：探究III期结直肠癌手术患者接受奥沙利铂联合卡培他滨治疗后血清粒细胞集落刺激因子（G-CSF）、人脂联素（ADPN）水平的变化，分析血清G-CSF、ADPN水平与肠道菌群失调的相关性。方法：选择2021年1月至2021年12月于我院接受手术治疗的220例III期结直肠癌患者为研究对象，均对其联合应用奥沙利铂与卡培他滨进行治疗，分析治疗前后患者血清G-CSF、ADPN水平变化，将入组患者按照肠道菌群情况分为肠道正常组（n=80）、菌群失调I度组（n=90）、菌群失调II度组（n=50），分析肠道菌群失调对入组患者治疗前后血清G-CSF、ADPN水平的影响，最后评估血清G-CSF、ADPN水平与肠道菌群失调的相关性。结果：（1）治疗后入组患者血清G-CSF、ADPN水平均较治疗前出现了明显的降低，前后比较有差异（P<0.05）；（2）治疗后菌群正常组患者血清G-CSF、ADPN水平明显低于菌群失调I度组，菌群失调I度组明显低于菌群失调II度组，各组间血清G-CSF、ADPN水平有差异（P<0.05）；（3）不同肠道菌群失调组患者肠道菌群数量存在差异，患者肠道菌群失调情况越严重，其肠球菌数量越高，乳杆菌数量越低（P<0.05）；（4）血清G-CSF、ADPN水平与乳杆菌数量呈现负相关（r=-0.872、-0.781，P<0.05），与肠球菌数量呈现正相关（r=0.772、0.819，P<0.05）。结论：Ⅲ期结直肠癌行手术治疗患者术后联用奥沙利铂与卡培他滨可以显著降低其血清G-CSF、ADPN水平，且其降低程度与患者肠道菌群失调情况相关，提示可以考虑将调节结直肠癌患者肠道菌群作为降低患者化疗后炎性反应措施之一推广于临床。

Expression of Serum G-CSF and ADPN in Postoperative Adjuvant Therapy of Oxaliplatin Combined with Capeox in Patients with Stage III Colorectal Cancer and Its Correlation with Intestinal Flora Imbalance

ABSTRACT Objective: To investigate the changes of serum granulocyte colony stimulating factor (G-CSF) and human adiponectin (ADPN) levels in patients with stage III colorectal cancer after receiving oxaliplatin combined with capeox, and to analyze the correlation between serum G-CSF and ADPN levels and intestinal flora imbalance. Methods: 220 patients with stage III colorectal cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the research objects. They were treated with oxaliplatin and capecitabine. The changes of serum G-CSF and ADPN levels before and after treatment were analyzed. The patients were divided into normal intestinal flora group (n=80), dysbacteriosis I group (n=90) In the second degree group (n=50), the effect of intestinal flora imbalance on the levels of serum G-CSF and ADPN before and after treatment was analyzed, and finally the correlation between the levels of serum G-CSF and ADPN and intestinal flora imbalance was evaluated. Results: (1) the levels of serum G-CSF and ADPN were lower than those before treatment (P<0.05); (2) After treatment, the levels of serum G-CSF and ADPN in patients with normal flora were lower than those in patients with flora imbalance I, and those in patients with flora imbalance I were significantly lower than those in patients with flora imbalance II. There was significant difference in the levels of serum G-CSF and ADPN among the groups (P<0.05); (3) There were differences in the number of intestinal flora in different intestinal flora imbalance groups. The more serious the intestinal flora imbalance, the higher the number of enterococci and the lower the number of Lactobacillus. The difference between the groups was different (P<0.05); (4) The levels of serum G-CSF and ADPN were negatively correlated with the number of Lactobacillus (r=-0.872, -0.781, P<0.05), and positively correlated with the number of Enterococcus (r=0.772, 0.819, P<0.05). Conclusion: The combination of oxaliplatin and capecitabine can significantly reduce the levels of serum G-CSF and ADPN in patients with stage III colorectal cancer, and the degree of reduction is related to the imbalance of intestinal flora, suggesting that the regulation of intestinal flora in patients with colorectal cancer can be considered as one of the measures to reduce the inflammatory response after chemotherapy.