不同术前准备的结肠癌患者腺癌组织中的微生物增殖情况

N. I. Simonenko, E. Zlatnik, N. I. Panova, O. G. Shulgina, A. Maksimov
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引用次数: 0

摘要

研究目的评估在结肠癌患者的复合术前准备中加入乳球蛋白对其肿瘤和切除线组织微生物群的影响。40名结肠癌II-III期患者(手术是治疗的第一阶段)在标准术前准备期间注射了从免疫牛初乳中获得的抗机会性肠道微生物抗体制剂,每次2克,每天两次,术前口服,连续3天(总剂量为12克)(主要组);40名患者接受标准抗生素预防治疗(对照组)。在切除的肿瘤和切除线组织样本中测定微生物群的定量组成。与对照组相比,主要研究组的肿瘤微生物污染总量低 9.2 倍;大肠杆菌和梭状芽孢杆菌的排泄频率在统计学上也显著降低(p = 0.004 和 0.03)。在研究的 12 种微生物代表中,大组患者肿瘤中的 6 种在统计学上明显低于对照组,而对照组中的 3 种则未检出。由于它们具有潜在的致病性(铜绿假单胞菌、金黄色葡萄球菌、白色念珠菌属真菌),因此可以认为主要组患者肿瘤中的微生物组成比对照组更有利。在非肿瘤肠道组织中也发现了类似的差异,其中肠杆菌属、链球菌属、梭菌属、拟杆菌属的含量在统计学上明显低于对照组。因此,口服牛初乳抗体可引起肿瘤和结肠组织微生物群的积极变化。考虑到微生物群可能会影响患者对化疗和免疫疗法的反应,我们建议将乳球蛋白用于此类患者的手术治疗。
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Microbiocenosis of adenocarcinoma tissue in colon cancer patients with different preoperative preparation
Purpose of the study. To assess the effect of inclusion of lactoglobulin in complex preoperative preparation of colon cancer patients on their tumor and resection line tissue microbiota.Materials and methods. 40 patients with colon cancer stages II–III, in whom the operation was the first stage of treatment, during standard preoperative preparation, were injected with a preparation of antibodies against opportunistic intestinal microorganisms obtained from colostrum of immunized cows, 2 g twice a day orally before surgery for 3 days (total dose of 12 g) (main group); 40 patients received standard antibiotic prophylaxis (control group). The quantitative composition of the microbiota was determined in the samples of the removed tumor and tissue of the resection line.Results. The total microbial contamination of the tumor was 9.2 times lower in the main group relative to the control group; the frequency of E.coli and Clostridiae excretion was also statistically significantly lower (p = 0.004 and 0.03, respectively). In the tumors of patients of the main group out of twelve studied representatives of microorganisms, the number of six was statistically significantly lower than in control group, and three of those found in the control group were not detected. Since they were potentially pathogenic (Pseudomonas aeruginosa, Staphylococcus aureus, fungi of the Candida spp.), the microbial composition of the tumor of patients in the main group can be considered more favorable than the control group. Similar differences were noted in non-t umor intestinal tissue, in which the content of Enterobacter spp, Streptococcus, Clostridiae, Peptostreptococci was statistically significantly lower than in the control group.Conclusion. Thus oral administration of colostrum antibodies caused positive changes in tumor and colon tissue microbiota. We suggest the application of lactoglobulin to be useful for surgical treatment of such patients taking into account the possible impact of microbiota in patients’ response to chemo- and immunotherapy.
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