Abstract:

Objective　To investigate the relationship of the serum levels of homocysteine (Hcy), apolipoprotein H (APOH), and reactive oxygen species (ROS) with intestinal flora imbalance and clinical characteristics in patients with colorectal cancer. Methods　Eighty-nine patients with colorectal cancer treated at Daxing Hospital from April 2021 to February 2024 were selected as a study group, including 50 males and 39 females who were (61.45±5.55) years old; 89 healthy people in the same period were selected as a control group, including 52 males and 37 females who were (61.33±5.22) years old. The serum levels of Hcy, APOH, and ROS were detected and compared. The fecal samples of the subjects were collected for bacterial culture, and the number of flora was counted. The numbers of intestinal flora between the study group and the control group were compared. The relationship of the serum levels of Hcy, APOH, and ROS with intestinal flora was analyzed by the Pearson correlation analysis. The clinical characteristics of the patients in the study group were sorted out, and the serum levels of Hcy, APOH, and ROS in the patients with different clinical characteristics were compared. χ² and t tests were used for the statistical analysis. Results　The serum levels of Hcy, APOH, and ROS in the study group were higher than those in the control group [(16.88±5.36) μmol/L vs. (10.54±3.02) μmol/L, (9.66±2.31) mg/L vs. (3.21±1.01) mg/L, and (1 332.58±302.52) U/ml vs. (542.35±30.25) U/ml], with statistical differences (t=9.700, 24.135, and 24.521; all P<0.05). The numbers of Fusobacterium nucleatum, Enterococcus faecalis, and Escherichia coli in the study group were higher than those in the control group [(15.36±2.55) CFU/g vs. (5.06±2.11) CFU/g, (11.13±2.09) CFU/g vs. (4.12±0.99) CFU/g, and (17.16±3.24) CFU/g vs. (5.24±2.11) CFU/g], and the numbers of Bacteroides, Lactobacillus, and Bifidobacterium were lower [(6.87±3.06) CFU/g vs. (16.56±2.44) CFU/g, (8.35±2.41) CFU/g vs. (17.65±4.74) CFU/g, and (6.33±2.05) CFU/g vs. (15.22±4.13) CFU/g], with statistical differences (t=29.539, 28.596, 29.084, 23.358, 16.500, and 18.190; all P<0.05]. The Pearson correlation analysis showed that the serum levels of Hcy, APOH, and ROS were positively correlated with the numbers of Fusobacterium nucleatum, Enterococcus faecalis, and Escherichia coli in the patients (r=0.755, 0.702, and 0.488; r=0.822, 0.733, and 0.577; r=0.801, 0.782, and 0.587; all P<0.05), and negatively with the numbers of Bacteroides, Lactobacillus, and Bifidobacterium (r=-0.632, -0.422, and -0.722; r=-0.664, -0.471, and -0.763; r=-0.678, -0.511, and -0.799; all P<0.05). The serum levels of Hcy, APOH, and ROS in the patients with lymph node metastasis, distant metastasis of tumor, tumor stage III-IV, and poor differentiation were higher than those in the patients without lymph node metastasis, without distant metastasis of tumor, with tumor stage I-II, and with moderate to high differentiation, with statistical differences (all P<0.05). Conclusions　The serum levels of Hcy, APOH, and ROS in patients with colorectal cancer are higher than those in healthy people. All the three are related to the intestinal flora imbalance in patients with tumor metastasis, stage, and differentiation.

Key words: Colorectal cancer,  , Homocysteine,  , Apolipoprotein H,  , Reactive oxygen,  , Intestinal flora,  , Clinical characteristics

摘要：

目的　探讨结直肠癌患者血清同型半胱氨酸（homocysteine，Hcy）、载脂蛋白H（apolipoprotein H，APOH）、活性氧（reactive oxygen species，ROS）水平与肠道菌群失调、临床特征的关系。方法　选取2021年4月至2024年2月西安大兴医院收治的结直肠癌患者89例作为研究组［男50例，女39例，年龄（61.45±5.55）岁］，另选取同期健康体检者89例作为对照组［52例，女37例，年龄（61.33±5.22）岁］。受试者均检测血清Hcy、APOH、ROS水平并进行比较。采集受试者粪便标本进行细菌培养，统计菌群数量，比较两组肠道菌群数量。应用Pearson相关性分析血清Hcy、APOH、ROS水平与肠道菌群的关系。整理研究组患者临床特征，比较不同临床特征患者血清Hcy、APOH、ROS水平。采用χ2检验、t检验进行统计分析。结果　研究组血清Hcy、APOH、ROS水平均高于对照组［（16.88±5.36）μmol/L比（10.54±3.02）μmol/L、（9.66±2.31）mg/L比（3.21±1.01）mg/L、（1 332.58±302.52）U/ml比（542.35±30.25）U/ml］，差异均有统计学意义（t=9.700、24.135、24.521，均P<0.05）。研究组具核梭杆菌、粪肠球菌、大肠埃希菌数量高于对照组［（15.36±2.55）CFU/g比（5.06±2.11）CFU/g、（11.13±2.09）CFU/g比（4.12±0.99）CFU/g、（17.16±3.24）CFU/g比（5.24±2.11）CFU/g］，拟杆菌、乳酸杆菌、双歧杆菌数量低于对照组［（6.87±3.06）CFU/g比（16.56±2.44）CFU/g、（8.35±2.41）CFU/g比（17.65±4.74）CFU/g、（6.33±2.05）CFU/g比（15.22±4.13）CFU/g］，差异均有统计学意义（t=29.539、28.596、29.084、23.358、16.500、18.190，均P<0.05）。Pearson相关性分析显示，血清Hcy、APOH、ROS水平与结直肠癌患者具核梭杆菌、粪肠球菌、大肠埃希菌数量呈正相关（r=0.755、0.702、0.488，均P<0.05；r=0.822、0.733、0.577，均P<0.05；r=0.801、0.782、0.587，均P<0.05），而与拟杆菌、乳酸杆菌、双歧杆菌数量呈负相关（r=-0.632、-0.422、-0.722，均P<0.05；r=-0.664、-0.471、-0.763，均P<0.05；r=-0.678、-0.511、-0.799，均P<0.05）。淋巴结转移、肿瘤远处转移、肿瘤分期为III～IV期、低分化程度患者血清Hcy、APOH、ROS水平均高于无淋巴结转移、肿瘤无远处转移、肿瘤分期为I～II期、中高分化程度的患者，差异均有统计学意义（均P<0.05）。结论　结直肠癌患者血清Hcy、APOH、ROS水平高于健康人群，且三者均与患者肠道菌群失调和肿瘤转移、分期、分化程度有关。

关键词: 结直肠癌,  ,  , 同型半胱氨酸,  ,  , 载脂蛋白H,  ,  , 活性氧,  ,  , 肠道菌群,  ,  , 临床特征