探討手術治療對大腸直腸癌患者腸道菌相的干擾以及飲食與營養對患者術後腸道菌相重建的影響

Abstract

腸道微生物在個體健康中扮演重要角色，包括能量代謝和免疫反應等功能。過去的臨床研究發現，大腸直腸癌患者的菌相出現特殊的組成，且近期研究也釐清部分菌種促進腫瘤生成的機制。然而，大腸直腸癌患者手術後腸道菌相的動態變化與組成仍不清楚。因此，本研究募集101名無癌症民眾以及134名大腸直腸癌患者的腸道菌相數據，建立本族群中非癌症對照組和大腸直腸癌患者的微生物差異標的。本研究同時持續追蹤收集患者手術後兩年間的菌相與生活飲食數據。結果顯示，腸道菌相的多樣性在手術後顯著下降，並在術後一年才趨向穩定。此外，我們觀察到發生排便異常和感覺神經異常的患者與其他患者的腸道菌相存在差異。並進一步以本族群的微生物差異，探討手術後腸道菌相的重建趨勢。相較於非癌症對照組，大腸直腸癌患者整體而言在手術後一年時，潛在優勢菌屬總量依舊低落，而潛在風險菌屬總量依舊較高。然而，進一步分析顯示，菌相組成較佳的患者攝取全麥食物和水果的頻率較高，而菌相組成較差的患者則更頻繁地攝取咖啡。整體而言，本研究以追蹤收案的研究方式呈現了手術治療對大腸直腸癌患者腸道菌相組成的長期影響，並分析治療間常見的後遺症與菌相之間潛在的關聯。最終，本研究發現了生活飲食習慣的選擇與菌相重建間存在重要的關聯性。

Gut microbiota plays crucial roles in health by regulating the energy metabolism and immune responses. A distinct gut microbiota composition is observed in patients with colorectal cancer (CRC), and some bacteria promotes its tumor development. However, the dynamic changes and regulation mechanisms of gut microbiota post-surgery in patients with CRC remain unclear. Therefore, in this study, we investigated the changes in the microbiota of 134 patients with CRC before and two years after surgery. The results revealed a significant decrease in the gut microbiota diversity after surgery, which tended to stabilize one-year post-surgery. Compared to other patients, differences in gut microbiota were observed in patients with abnormal bowel movements and sensory nerve abnormalities. Additionally, we identified several microbes at the genus level that were enriched in non-cancer controls and patients with CRC. We investigated the trends in gut microbiota reconstruction after surgery using these markers. Overall, compared to the non-cancer control group, patients with CRC exhibited high levels of CRC-enriched genera one-year post-surgery, whereas the levels of control-enriched genera remained low. Further analysis indicated that patients with a favorable gut microbiota composition exhibited a high frequency of whole grain food and fruit consumption, whereas those with an unfavorable composition exhibited a high frequency of coffee intake. In conclusion, this follow-up study demonstrated the long-term impact of surgical treatment on the gut microbiota composition of patients with CRC and elucidated the dietary effects on the restructuring of gut microbiota after surgery.