目的 探究结肠癌患者肿瘤浸润淋巴细胞(TIL)表型与临床病理特征和肠道菌群的关系。 方法 选取 2017 年 6 月至 2023 年 2 月湖北省十堰市太和医院收治的 76 例结肠癌患者为结肠癌组,并选择同期体检的 76 例健康人为对照组。 检测两 组受试者 TIL 表型表达水平,荧光定量 PCR 检测肠道菌群,收集结肠癌患者临床病理资料。 采用 Spearman 分析 TIL 表型与肠 道菌群的相关性。 结果 与对照组相比,结肠癌组 CD4 + T 细胞水平显著升高[(28. 05±5. 48)% 比(32. 49±6. 13)%],CD3 + T 细 胞、CD8 + T 细胞水平显著降低[(60. 47±6. 53)%比(53. 17±6. 37)%]、[(30. 69±6. 38)%比(24. 85±6. 42)%] (P<0. 05)。 根据 结肠癌患者 CD3 + T 细胞(52. 62%)、CD8 + T 细胞(25. 87%)、CD4 + T 细胞(31. 94%)的中位值,将其分为 CD3 + T 细胞高表达 38 例,CD3 + T 细胞低表达 38 例,CD8 + T 细胞高表达 38 例,CD8 + T 细胞低表达 38 例,CD4 + T 细胞高表达 38 例,CD4 + T 细胞低表 达 38 例。 有淋巴结转移、肿瘤分化程度越高、TNM 分期越高,在 CD3 + T 细胞、CD8 + T 细胞、CD4 + T 细胞高表达、低表达患者间 差异有统计学意义( χ 2 = 5. 330、4. 659、6. 786;χ 2 = 7. 962、10. 483、4. 343;χ 2 = 11. 120、7. 280、13. 300;P< 0. 05)。 与对照组相 比,结肠癌组脆弱拟杆菌、大肠埃希菌、肠球菌数量显著增加[(6. 58±0. 83) lgN/ g 比(8. 59±1. 36) lgN/ g]、[(7. 36±1. 04) lgN/ g 比(9. 73±1. 25) lgN/ g]、[(7. 21±1. 08) lgN/ g 比(9. 28±1. 74) lgN/ g],乳酸杆菌、双歧杆菌数量显著下降[(8. 85±1. 46) lgN/ g 比 (6. 34±1. 22) lgN/ g]、[(8. 94±1. 09) lgN/ g 比(6. 17±1. 32) lgN/ g](P<0. 05)。 Spearman 相关分析结果显示,结肠癌患者脆弱拟 杆菌、大肠埃希菌、肠球菌与 CD3 + 、CD8 + T 细胞占比呈负相关( r = -0. 482、- 0. 459、- 0. 532,P< 0. 05;r = - 0. 438、- 0. 472、- 0. 508,P<0. 05),乳酸杆菌、双歧杆菌与 CD3 + 、CD8 + T 细胞占比呈正相关( r = 0. 581、0. 507,P< 0. 05;r = 0. 536、0. 467,P< 0. 05),脆弱拟杆菌、大肠埃希菌、肠球菌与 CD4 + T 细胞占比呈正相关(r = 0. 483、0. 495、0. 461,P<0. 05),乳酸杆菌、双歧杆菌 与 CD4 + T 细胞占比呈负相关(r = -0. 563、-0. 579,P<0. 05)。 结论 结肠癌患者 TIL 中表型 CD3 + T 细胞、CD8 + T 细胞、CD4 + T 细胞与临床病理特征和肠道菌群存在一定关系。

Objective To explore the relationship between the phenotype of tumor - infiltrating lymphocytes TIL and clinicopathological characteristics and gut microbiota in patients with colon cancer. Method From June 2017 to February 2023 76 colon cancer patients admitted to Taihe Hospital were collected as the colon cancer group and 76 healthy individuals who underwent physical examinations during the same period were collected as the control group. The TIL phenotype expression levels of two groups were detected fluorescent quantitative PCR was applied to detect gut microbiota and the clinical and pathological data of colon cancer patients were collected. Spearman was applied to analyze the correlation between TIL phenotype and gut microbiota. Result Compared with the control group the level of CD4 + T cell in the colon cancer group was obviously increased 28. 05± 5. 48 % vs 32. 49± 6. 13 % while the levels of CD3 + T cell and CD8 + T cell were obviously reduced 60. 47 ± 6. 53 % vs 53. 17 ± 6. 37 % 30. 69±6. 38 % vs 24. 85 ± 6. 42 % P < 0. 05 . According to the median values of CD3 + T cell 52. 62% CD8 + T cell 25. 87% and CD4 + T cell 31. 94% colon cancer patients were divided into 38 cases with high expression of CD3 + T cell 38 cases with low expression of CD3 + T cell 38 cases with high expression of CD8 + T cell 38 cases with low expression of CD8 + T cell 38 cases with high expression of CD4 + T cell and 38 cases with low expression of CD4 + T cell. There were lymph node metastasis the higher the degree of tumor differentiation the higher the TNM stage and the difference between high and low expression of CD3 + T cell CD8 + T cell and CD4 + T cell was statistically significant χ 2 = 5. 330 4. 659 6. 786 χ 2 = 7. 962 10. 483 4. 343 χ 2 = 11. 120 7. 280 13. 300 P<0. 05 . Compared with the control group the numbers of Bacteroides fragilis Escherichia coli and Enterococcus in the colon cancer group increased obviously 6. 58 ± 0. 83 lgN/ g vs 8. 59 ± 1. 36 lgN/ g 7. 36 ± 1. 04 lgN/ g vs 9. 73 ± 1. 25 lgN/ g 7. 21±1. 08 lgN/ g vs 9. 28±1. 74 lgN/ g while the numbers of Lactobacillus and Bifidobacterium decreased obviously 8. 85±1. 46 lgN/ g vs 6. 34± 1. 22 lgN/ g 8. 94± 1. 09 lgN/ g vs 6. 17± 1. 32 lgN/ g P< 0. 05 . Spearman correlation analysis showed that Bacteroides fragilis Escherichia coli and Enterococcus were negatively correlated with the proportion of CD3 + T cell and CD8 + T cell in colon cancer patients r = - 0. 482 - 0. 459 - 0. 532 r = - 0. 438 - 0. 472 - 0. 508 P < 0. 05 Lactobacillus and Bifidobacterium were positively correlated with the proportion of CD3 + T cell and CD8 + T cell r = 0. 581 0. 507 r = 0. 536 0. 467 P<0. 05 Bacteroides flimsii Escherichia coli and Enterococcus were positively correlated with the proportion of CD4 + T cell r = 0. 483 0. 495 0. 461 P<0. 05 and Lactobacillus and Bifidobacterium were negatively correlated with the proportion of CD4 + T cell r = -0. 563 -0. 579 P<0. 05 . Conclusion The phenotypes of CD3 + T cell CD8 + T cell and CD4 + T cell in TIL of colon cancer patients have certain relationship to the clinicopathological characteristics and gut microbiota.