结肠腺瘤性息肉内镜下切除术患者肠道微生态变化及其与预后的关联OA

Objective To investigate changes in intestinal microecology and their association with prognosis in patients undergoing endoscopic resection of colonic adenomatous polyps.Methods A total of 116 patients with colonic adenomatous polyps who underwent endoscopic resection were en-rolled in adenomatous polyp group,and 116 patients with non-adenomatous polyps who underwent en-doscopic resection during the same period were enrolled in non-adenomatous polyp group.Baseline data and preoperative intestinal bacterial counts were compared between the two groups.Preoperative intestinal bacterial counts were analyzed according to different clinical characteristics in patients with adenomatous polyps,and dynamic changes in intestinal bacteria before and after surgery,as well as intestinal microecological indices at 12 months postoperatively between patients with and without re-currence,were compared.Results There were no significant differences between the two groups in sex,age,maximum lesion diameter,lesion morphology,lesion number,orlesion location(P＞0.05).Before surgery,compared with the non-adenomatous polyp group,the adenomatous polyp group had significantly lower counts of Lactobacillus and Bifidobacterium and significantly higher counts of Esch-erichia coli(P＜0.05),Compared with patients who had a maximum lesion diameter＜1.5 cm,a protruding morphology,a solitary lesion,or a proximal colon location,those with a maximum lesion diameter ≥ 1.5 cm,a superficial morphology,multiple lesions,or a distal colon location had signif-icantly lower counts of Lactobacillus and Bifidobacterium and significantly higher counts of Escherichi-a coli before surgery(P＜0.05).At 3 and 12 months after surgery,the adenomatous polyp group showed significant increases in Lactobacillus and Bifidobacterium counts,significant decreases in Escherichia coli counts,and significant elevations in Chao1 and Shannon indices compared with pre-operative values(P＜0.05),At 12 months post operatively,compared with patients without recur-rence,those with recurrence had significantly lower counts of Lactobacillus and Bifidobacterium,sig-nificantly higher counts of Escherichia coli,and significantly lower Chao1 and Shannon indices(P＜0.05).Conclusion Both adenomatous polyps and their postoperative recurrence are closely associ-ated with intestinal dysbiosis.Although endoscopic resection can effectively improve the structure and diversity of the intestinal microbiota,persistent dysbiosis may serve as an important biological marker for recurrence.