背景:结直肠息肉,其特点是复发率高,代表肠道的肿瘤前状况。由于发病机制尚不清楚,非遗传性复发性结直肠息肉的一线治疗仅限于内镜切除术.尽管最近的研究表明肠道菌群失调和息肉之间存在机械联系,细菌在病变周围粘膜中的确切组成和作用,而不是粪便,保持不安。
目的:阐明复发性肠息肉周围或10cm远端的粘膜中细菌的组成和多样性。
方法:收集4例腺瘤性息肉(Ade)患者的粘膜样本,七个与非阿德(Pol)一致,10与当前Pol但以前的Ade,和六个健康的人,通过16SrDNA测序评估细菌模式。线性判别分析和学生t检验用于鉴定具有不同结直肠息肉表型的组之间的属水平细菌差异。采用Pearson相关系数评价肠道菌属水平与临床指标的相关性。
结果:结果证实,与健康个体相比,所有类型息肉患者的益生菌水平降低,病原菌富集。这些改变并不局限于与息肉相邻的0.5cm内的粘膜,但也存在于距离病变10厘米远的组织学正常组织中。在正常情况下的个体的粘膜中观察到细菌多样性的显着差异,波尔,还有Ade.革兰氏阴性细菌的丰度增加,包括克雷伯菌,Plesiomonas,和Cronobacter,在Pol组和Ade组中观察到,这表明对抗生素的耐药性可能是细菌相关有害环境的危险因素之一。同时,年龄和性别与细菌变化有关,表明性激素的潜在参与。
结论:这些初步结果支持肠道菌群失调是复发性息肉的重要危险因素,尤其是腺瘤.靶向特异性致病菌可以减轻息肉的复发。
BACKGROUND: Colorectal polyps, which are characterized by a high recurrence rate, represent preneoplastic conditions of the intestine. Due to unclear mechanisms of pathogenesis, first-line therapies for non-hereditary recurrent colorectal polyps are limited to endoscopic resection. Although recent studies suggest a mechanistic link between intestinal dysbiosis and polyps, the exact compositions and roles of bacteria in the mucosa around the lesions, rather than feces, remain unsettled.
OBJECTIVE: To clarify the composition and diversity of bacteria in the mucosa surrounding or 10 cm distal to recurrent intestinal polyps.
METHODS: Mucosal samples were collected from four patients consistently with adenomatous polyps (Ade), seven consistently with non-Ade (Pol), ten with current Pol but previous Ade, and six healthy individuals, and bacterial patterns were evaluated by 16S rDNA sequencing. Linear discriminant analysis and Student\'s t-tests were used to identify the genus-level bacteria differences between groups with different colorectal
polyp phenotypes. Pearson\'s correlation coefficients were used to evaluate the correlation between intestinal bacteria at the genus level and clinical indicators.
RESULTS: The results confirmed a decreased level of probiotics and an enrichment of pathogenic bacteria in patients with all types of polyps compared to healthy individuals. These changes were not restricted to the mucosa within 0.5 cm adjacent to the polyps, but also existed in histologically normal tissue 10 cm distal from the lesions. Significant differences in bacterial diversity were observed in the mucosa from individuals with normal conditions, Pol, and Ade. Increased abundance of Gram-negative bacteria, including Klebsiella, Plesiomonas, and Cronobacter, was observed in Pol group and Ade group, suggesting that resistance to antibiotics may be one risk factor for bacterium-related harmful environment. Meanwhile, age and gender were linked to bacteria changes, indicating the potential involvement of sex hormones.
CONCLUSIONS: These preliminary results support intestinal dysbiosis as an important risk factor for recurrent polyps, especially adenoma. Targeting specific pathogenic bacteria may attenuate the recurrence of polyps.