细胞因子在胆管癌组织中的表达及与小肠细菌过度生长的关系探讨

Study on the Relation between the Overexpression of Cytokines and Small Intestinal Bacterial Overgrowth in Cholangiocarcinoma

摘要: 目的 本研究通过检测胆管癌(CCA)患者小肠细菌过度生长(small intestinal bacterial overgrowth, SIBO)及胆管癌组织中细胞因子(IL-1β、IL-6和TNF-α)的表达水平，来探讨胆管癌患者中小肠细菌过度生长的发病率及其与炎症介质水平的关系。方法：在30例胆管癌患者及30例健康对照中使用葡萄糖氢呼气实验(glucose hydrogen breath test, GHBT)检测小肠细菌过度生长的发生情况；采用免疫组织化学技术(immunohistochemistry, IHC)检测胆管癌组织中IL-1β、IL-6和TNF-α的表达情况。结果：1) 胆管癌组SIBO阳性率为53.3%，健康对照组SIBO阳性率为16.7%，胆管癌组SIBO阳性率明显高于对照组(X² = 8.864, P < 0.05)。2) 在胆管癌患者SIBO阳性组和阴性组间IL-1β、IL-6、TNF-α的表达水平有显著差异(P = 0.03, 0.024, 0.01)。结论：胆管癌患者较健康人群更容易发生SIBO，SIBO可能通过促进IL-1β、IL-6及TNF-α的表达影响胰腺癌的发生发展。

Abstract: Objective: In this work, we investigated the morbidity of small intestinal bacterial overgrowth (SIBO) and the expression of cytokines (IL-1β, IL-6 and TNF-α) level in CCA, to analyze the changes between SIBO and inflammatory medium level. Methods: 30 patients with CCA and 30 healthy controls were included in this study. Glucose hydrogen breath test (GHBT) was used to detect SIBO. The immunohistochemistry (IHC) was used to detect the expression of IL-1β, IL-6 and TNF-α in CCA tissues. Results: 1) The SIBO positive rate was 53.3% in 30 patients with CCA, and 16.7% in 30 healthy controls. The SIBO positive rate was significantly higher in the CCA group than in the control group (X² = 8.864, P < 0.05). 2) The expression levels of IL-1β, IL-6, TNF-α were significantly different between the SIBO(+) group and the SIBO(−) group in patients with CCA (P = 0.03, 0.024, 0.01). Conclusions: Patients with CCA were more likely to develop SIBO than healthy people. SIBO may influence the development of CCA by promoting the expression of IL-1β, IL-6 and TNF-α.