恶液质与肠道细菌移位对局限型进展期胃癌患者临床结局的影响

摘要

Objective To investigate the relationship between bacterial translocation and gastric cancer patients with ca -chexia.Methods 120 patients with locally advanced gastric cancer were divided into patients with cachexia (group A,60 cases) and patients without cachexia (group B,60 cases).Then the patients were divided into cachexia bacterial translocation positive group(group C),cachexia bacterial translocation negative group (group D),non-cachexia bacterial translocation positive group (group E)and non-cachexia bacterial translocation negative group (group F)according to the result of cultured peripheral blood . 60 healthy volunteers were the control group (group G).The intestinal bacteria were cultivated by peripheral blood;serum tumor necrosis factor α(TNF-α),and interleukin 1(IL-1)were tested;and the 2-year survival rate was calculated .Results ①The bac-terial translocation incidence rates of group A and group B were 26.67% and 6.67%;the bacterial culture results of group G were negative.The bacterial translocation rate in group A was significantly higher than that of group B (P<0.05).②The TNF-αand IL-1αlevel in group C were significantly higher than those of group D ,E,F and G(P<0.05).③The 2-year survival rates in group C,D,E,and F were 12.50%,22.73%, 50.00%,and 46.43%.Conclusion Intestinal bacterial translocation plays an important part in the occurrence and development of cachexia in gastric cancer .%目的：探讨肠道细菌移位与胃癌恶液质患者的关系。方法选择原发性局限型进展期胃癌患者120例，根据有无恶液质表现分为胃癌恶液质组（ A组，60例）和胃癌无恶液质组（ B组，60例）。外周血培养后，根据结果再分为恶液质细菌移位阳性组（C组）、恶液质细菌移位阴性组（D组），非恶液质细菌移位阳性组（E组）及非恶液质细菌移位阴性组（ F组）。选择60例健康体检者作为对照组（ G组）。外周血培养肠道细菌；检测血清肿瘤坏死因子α（ TNF-α）和白细胞介素1（IL-1）；随访计算2年生存率。结果①A组细菌移位发生率为26．67％；B组细菌移位发生率为6．67％；G组细菌培养结果均为阴性；A组的细菌移位率显著高于B组（P＜0．05）。②C组白介素1α（IL-1α）和肿瘤坏死因子（TNF-α）水平明显高于D组、E组、F组和G组（P＜0．05））；③C组2年存活率最低（12．50％），D组为22．73％，E组为50．00％，F组为46．43％。结论肠道菌群移位在胃癌患者恶液质的发生发展过程中起到重要作用。