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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (4): 619-624. doi: 10.19723/j.issn.1671-167X.2023.04.008

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Relationship between chronic radiation enteritis of cervical cancer and gut microbiota

Hai-hong JIANG1,Xiao-fan LI2,Jian-liu WANG1,*()   

  1. 1. Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing 100044, China
    2. Department of Radiation Oncology, Peking University Cancer Hospital, Beijing 100142, China
  • Received:2020-12-24 Online:2023-08-18 Published:2023-08-03
  • Contact: Jian-liu WANG E-mail:wangjianliu1203@163.com
  • Supported by:
    the National Key Technology Research and Development Program of China(2015BAI13B06)

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Abstract:

Objective: To explore the relationship between gut microbiota and chronic radiation enteritis of cervical cancer patients. Methods: Fecal samples were collected from 34 patients with cervical cancer who had received radiotherapy for at least 6 months but less than 2 years. The patients were divi-ded into mild toxicity group (mild, M) with no symptoms or mild symptoms and severe toxicity group (severe, S) with severe symptoms by clinical diagnosis of radiation enteritis, modified inflammatory bo-wel disease questionnaire (IBDQ) and Vaizey questionnaire. DNA extracted from fecal samples was sequenced and analyzed by 16S rRNA sequencing method. The analysis indexes included α-diversity, β-diversity, taxonomic composition analysis, taxonomic hierarchy tree and linear discriminant analysis (LDA) effect size (LEfSe). Results: From the perspective of species diversity, most indices of α diversity in group M were higher than those in group S. Although there was no significant difference, it also indicated a correlation between low species diversity and severity of intestinal symptoms to some extent. There was also a significant difference in the distribution of β diversity between the two groups, indicating that the microbial characteristics were different between the two groups. From the perspective of species composition, the M group had higher Firmicutes [66.5% (M) vs. 56.0% (S)] and lower Proteobacteria [4.1% (M) vs. 13.9% (S)] than the S group at the level of phyla. At the level of genus, there were also significant differences between the two groups: Shigella [2.7% (M) vs. 8.5% (S)], Faeca-libacterium [7.0% (M) vs. 2.7% (S)], Lachnospiraceae_Clostridium [1.3% (M) vs. 4.7% (S)]. Through LEfSe also found some species with statistically significant differences between the two groups. The abundance of Peptoniphilus, Azospirillum and Actinomyces in group M was significantly higher, while the abundance of Veillonellaceae, Rhodobacteraceae, and Rhodobacterales in group S was significantly higher. The taxonomic hierarchy tree also intuitively showed the difference in species composition between the two groups at each taxonomic level in space. Conclusion: The severity of chronic radiation enteritis of cervical cancer is closely related to the characteristics and composition of gut microbiota.

Key words: Cervical cancer, Radiotherapy, Chronic radiation enteritis, Gut microbiota

CLC Number: 

  • R737.3

Table 1

Questionnaire score and grouping of patients"

Sample number IBDQ Vaizey Clinical information Groups
1 198 9 M
2 184 15 Intestinal dysfunction, chronic diarrhea S
3 138 16 S
4 140 13 S
5 214 4 M
6 166 2 Colonoscopy rectal inflammatory changes, occasionally hematochezia S
7 N N Intestinal dysfunction, chronic diarrhea S
8 155 14 S
9 180 8 S
10 218 1 M
11 150 7 S
12 N N Intestinal dysfunction, chronic diarrhea S
13 207 1 M
14 199 9 M
15 N N Intestinal dysfunction, chronic constipation S
16 104 8 S
17 224 0 M
18 212 1 M
19 215 5 M
20 219 8 M
21 184 13 Intestinal dysfunction, occasional blood in stool S
22 171 13 S
23 195 10 S
24 164 5 S
25 213 0 Intestinal dysfunction, stool 5-6 times a day S
26 200 6 Intestinal dysfunction. CT showed thickened and unsmooth wall of sigmoid colon and rectum S
27 208 11 M
28 216 4 M
29 198 3 M
30 213 12 M
31 172 20 S
32 209 3 M
33 180 5 M
34 215 0 M
Median 198 7
Quartile(more severe direction) 169 12

Figure 1

Comparison of microbial diversity between M group and S group A, comparison of α diversity between group M and group S was shown in boxplot (the middle horizontal line was the median, the upper and lower horizontal lines were the upper and lower quartiles). It could be seen that most of the indicators in group M were higher than that in group S, although there was no significant difference; B, C, PCoA and NMDS analysis of Group M and Group S, it can be intuitively seen the difference in spatial distribution of the two groups (different colors represent different groups, each small dot represents a sample, and the large circle represents confidence ellipse). Faith_pd, Faith's phylogenetic diversity; Pielou_e, Pielou's evenness; M, mild; S, severe; PCoA, principal coordinates analysis; NMDS, nonmetric multidimensional scaling."

Figure 2

Analysis of microbial species differences between M group and S group A, relative abundance of group M and group S at the phylum level; B, relative abundance of group M and group S at the genus level; C, D, LEfSe analysis of group M and group S. Cladogram (C) shows the taxonomic hierarchy of the major taxa from phylum to genus. Histogram (D) shows the logarithmic score values of LDA analysis of each taxon; E, taxonomic hierarchy tree diagram of group M and group S. Large circles with different colors in the figure indicate different taxonomic levels including phylum, class, order, family and genus. It can be intuitively seen the position of microbial species difference between the two groups in each classification grade. M, mild; S, severe; LEFSe, LDA effect size; LDA, linear discriminant analysis."

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