结直肠癌患者肠道差异菌属筛选及生活质量与抑郁的中介效应分析OA
Screening of differential intestinal bacterial genera and mediating effect analysis between quality of life and depression in colorectal cancer patients
目的 筛选结直肠癌抑郁与非抑郁患者的肠道差异菌属,基于相关性分析结果,探讨菌属相对丰度在生活质量与抑郁程度间的中介作用.方法 前瞻性选取淳安县第一人民医院2021年8月至2023年8月收治的98例结直肠癌患者为研究对象.根据抑郁自评量表(SDS)评分,以53分为临界值,将所有患者分为抑郁组24例和非抑郁组74例.采用欧洲癌症研究与治疗组织生命质量核心量表30(EORTC QLQ-C30)评价患者生活质量.采集患者新鲜成形粪便,进行16S rRNA基因测序测定,对比两组患者肠道菌群多样性特征.采用Pearson相关分析生活质量与肠道差异菌属相对丰度及抑郁程度的关系,采用中介效应分析菌属相对丰度在结直肠癌患者生活质量与抑郁程度间的作用.结果 抑郁组EORTC QLQ-C30各维度评分及总分均低于非抑郁组(均P＜0.05),肠道菌群Shannon指数、Chao1指数、ACE指数均大于非抑郁组(均P＜0.05),粪球菌属、小类杆菌属、柔嫩梭菌属、普氏菌属、拟杆菌属相对丰度均低于非抑郁组(均P＜0.05).Pearson相关分析显示,结直肠癌患者EORTC QLQ-C30总分与粪球菌属相对丰度呈正相关(r=0.743,P＜0.05),与SDS评分呈负相关(r=-0.517,P＜0.05),粪球菌属相对丰度与SDS评分呈负相关(r=-0.502,P＜0.05).中介效应分析结果显示,粪球菌属相对丰度在EORTCQLQ-C30总分与SDS评分之间存在部分中介效应,中介效应为-0.376,总效应值为-4.593,中介效应占总效应的8.19％.结论 结直肠癌患者生活质量与抑郁程度有关,且粪球菌属相对丰度在其中发挥了部分中介作用.
Objective To screen differential intestinal bacterial genera between depressed and non-depressed patients with colorectal cancer(CRC),and to explore the mediating role of bacterial abundance in the relationship between quality of life and depression severity.Methods A total of 98 CRC patients admitted to Chun'an First People's Hospital from August 2021 to August 2023 were enrolled.According to Self-Rating Depression Scale(SDS)scores with a cut-off of 53,patients were divided into a depression group(n=24)and a non-depression group(n=74).Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30).Fresh stool samples were collected for 16S rRNA gene sequencing to compare gut microbiota profiles between groups.Pearson correlation analysis was used to examine relationships among quality of life,differential bacterial abundance,and depression scores.Mediation analysis was performed to evaluate the role of bacterial abundance in the association between quality of life and depression in CRC patients.Results The depression group showed significantly lower scores in all EORTC QLQ-C30 domains and total score(all P＜0.05).Gut microbiota diversity indices(Shannon,Chao1,and ACE)were higher in the depression group(all P＜0.05),while the relative abundances of Coprococcus,Dialister,Faecalibacterium,Prevotella,and Bacteroides were lower(all P＜0.05).Pearson analysis revealed that the total score of EORTC QLQ-C30 were positively correlated with Coprococcus abundance(r=0.743,P＜0.05)and negatively correlated with SDS scores(r=-0.517,P＜0.05).Coprococcus abundance was also negatively correlated with SDS scores(r=-0.502,P＜0.05).Mediation analysis indicated that Coprococcus abundance partially mediated the relationship between the total score of EORTC QLQ-C30 and SDS scores,with a mediating effect of-0.376,a total effect of-4.593,accounting for 8.19％of the total effect.Conclusion Quality of life is associated with depression severity in CRC patients,and Coprococcus abundance plays a partial mediating role in this association.
徐芬芬;何慧娟;朱明辉;余争垚;洪文忠
311700 浙江省人民医院淳安分院(淳安县第一人民医院)肛肠外科311700 浙江省人民医院淳安分院(淳安县第一人民医院)肛肠外科311700 浙江省人民医院淳安分院(淳安县第一人民医院)肛肠外科311700 浙江省人民医院淳安分院(淳安县第一人民医院)肛肠外科311700 浙江省人民医院淳安分院(淳安县第一人民医院)肛肠外科
结直肠癌粪球菌属生活质量抑郁肠道菌群中介效应
Colorectal cancerCoprococcusQuality of lifeDepressionIntestinal floraMediating effect
《浙江医学》 2026 (5)
476-480,5
浙江省医药卫生科技计划项目(2020KY810)
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