中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2012年
2期
69-73
,共5页
米磊%郑红梅%张坚%焦学龙%张佃良
米磊%鄭紅梅%張堅%焦學龍%張佃良
미뢰%정홍매%장견%초학룡%장전량
恶液质%细菌移位%胃癌%细胞因子%结局
噁液質%細菌移位%胃癌%細胞因子%結跼
악액질%세균이위%위암%세포인자%결국
Cachexia%Bacterial translocstion%Gastric cancer%Cytokine%Outcome
目的 探讨局限型进展期胃癌患者肠道细菌移位与恶液质的关系及其对患者结局的影响.方法 选取2008年1月至2009年7月预行手术治疗的胃癌恶液质患者60例,年龄及性别匹配的胃癌非恶液质患者50例,健康对照者55例.采用聚合酶链反应检测外周血细菌DNA片段,酶联免疫吸附实验检测外周血细胞因子浓度,流式细胞法检测外周血免疫学指标.所有入选对象随访两年,计算两年生存率.结果 恶液质组细菌移位发生率( 15/60,25.0％)显著高于非恶液质组(4/50,8.0％,P=0.019)和健康对照组(0/55,0.0％,P=0.000).细菌移位阳性的恶液质患者白细胞介素-1α (IL-1α)、IL-6、肿瘤坏死因子-α和干扰素-γ水平均显著高于细菌移位阴性的恶液质患者(P=0.012、P=0.003、P=0.036、P=0.017)和细菌移位阳性的非恶液质患者(P=0.011、P=0.034、P=0.000、P=0.022),并且其两年生存率明显低于细菌移位阴性的恶液质患者(P=0.023).胃癌患者CD3+T、CD4+T和自然杀伤细胞水平及CD4+ T/CD8+T显著低于健康对照组(P=0.023、P=0.031、P=0.016、P=0.041),CD8+T细胞水平显著高于健康对照组(P=0.038).结论 肠道细菌移位可能与局限型进展期胃癌患者恶液质的发生有关,并影响恶液质患者的长期生存.
目的 探討跼限型進展期胃癌患者腸道細菌移位與噁液質的關繫及其對患者結跼的影響.方法 選取2008年1月至2009年7月預行手術治療的胃癌噁液質患者60例,年齡及性彆匹配的胃癌非噁液質患者50例,健康對照者55例.採用聚閤酶鏈反應檢測外週血細菌DNA片段,酶聯免疫吸附實驗檢測外週血細胞因子濃度,流式細胞法檢測外週血免疫學指標.所有入選對象隨訪兩年,計算兩年生存率.結果 噁液質組細菌移位髮生率( 15/60,25.0％)顯著高于非噁液質組(4/50,8.0％,P=0.019)和健康對照組(0/55,0.0％,P=0.000).細菌移位暘性的噁液質患者白細胞介素-1α (IL-1α)、IL-6、腫瘤壞死因子-α和榦擾素-γ水平均顯著高于細菌移位陰性的噁液質患者(P=0.012、P=0.003、P=0.036、P=0.017)和細菌移位暘性的非噁液質患者(P=0.011、P=0.034、P=0.000、P=0.022),併且其兩年生存率明顯低于細菌移位陰性的噁液質患者(P=0.023).胃癌患者CD3+T、CD4+T和自然殺傷細胞水平及CD4+ T/CD8+T顯著低于健康對照組(P=0.023、P=0.031、P=0.016、P=0.041),CD8+T細胞水平顯著高于健康對照組(P=0.038).結論 腸道細菌移位可能與跼限型進展期胃癌患者噁液質的髮生有關,併影響噁液質患者的長期生存.
목적 탐토국한형진전기위암환자장도세균이위여악액질적관계급기대환자결국적영향.방법 선취2008년1월지2009년7월예행수술치료적위암악액질환자60례,년령급성별필배적위암비악액질환자50례,건강대조자55례.채용취합매련반응검측외주혈세균DNA편단,매련면역흡부실험검측외주혈세포인자농도,류식세포법검측외주혈면역학지표.소유입선대상수방량년,계산량년생존솔.결과 악액질조세균이위발생솔( 15/60,25.0％)현저고우비악액질조(4/50,8.0％,P=0.019)화건강대조조(0/55,0.0％,P=0.000).세균이위양성적악액질환자백세포개소-1α (IL-1α)、IL-6、종류배사인자-α화간우소-γ수평균현저고우세균이위음성적악액질환자(P=0.012、P=0.003、P=0.036、P=0.017)화세균이위양성적비악액질환자(P=0.011、P=0.034、P=0.000、P=0.022),병차기량년생존솔명현저우세균이위음성적악액질환자(P=0.023).위암환자CD3+T、CD4+T화자연살상세포수평급CD4+ T/CD8+T현저저우건강대조조(P=0.023、P=0.031、P=0.016、P=0.041),CD8+T세포수평현저고우건강대조조(P=0.038).결론 장도세균이위가능여국한형진전기위암환자악액질적발생유관,병영향악액질환자적장기생존.
Objective To investigate the association of bacterial translocation (BT) with cachexia and its impact on the outcome of gastric cancer patients.Methods Sixty cachectic gastric cancer patients,50 age- and sex-matched non-cachectic gastric cancer patients,and 55 healthy controls were enrolled in this study between January 2008 and July 2009.Polymerase chain reaction was performed to detect bacterial DNA in the peripheral blood of cancer patients and healthy controls,Cytokine levels were tested by enzyme-linked immunosorbent assay.Flow cytometry was used to detect immune indicators.All the enrolled patients were followed up for two years,and the two-year survival rate was calculated.Results The BT ratio was significantly higher in cachectic patients than in non-cachectic patients (25.0％ vs.8.0％,P =0.019) and healthy controls (25.0％ vs.0.0％,P =0.000).BT-positive cachectic patients had significantly higher levels of IL-1α,IL-6,TNF-α,and IFN-γ compared with BT-negative cachectic patients ( P =0.012,0.003,0.036,and 0.017,respectively ) and BT-positive non-cachectic patients ( P =0.011,0.034,0.000,and 0.022,respectively).The two-year survival rate in BT-positive cachectic patients was significantly lower than in BT-negative cachectic patients (P =0.023 ).The levels of CD3 +T,CD4+ T,natural killer cells,and CD4 + T/CD8 + T in gastric cancer patients were significantly lower than in healthy controls ( P =0.023,0.031,0.016,0.041,respectively),whereas CD8 + T level was significantly higher in gastric cancer patients than in healthy controls (P =0.038).Conclusion BT may contribute to the development of cancer cachexia and influence the long-term survival of locally advanced gastric cancer patients.
