结直肠癌患者舌苔变化与舌苔菌群和肠道菌群的相关性研究

目的：探讨结直肠癌患者腻苔舌苔变化与舌苔菌群和肠道菌群的相关性。方法：选取2022年9月至2023年3月哈尔滨医科大学附属第一医院结直肠外科收治的63例结直肠癌患者，根据其舌象特征分层随机抽样采集其中12例黄腻苔和9例白腻苔患者的舌苔、癌组织及癌旁组织样本，同时采集6例肠镜检查无异常的薄白苔健康人舌苔样本。所有样本均行高通量5R 16S rDNA测序分析。结果：结直肠癌患者舌苔变化以黄腻苔和白腻苔为主。舌苔奇异菌属（Atopobium）和肠道颗粒链菌属（Granulicatella）可能是黄腻苔结直肠癌患者的特征性菌属；舌苔孪生球菌属（Gemella）和肠道罗氏菌属（Roseburia）、希瓦氏菌属（Shewanella）可能是白腻苔结直肠癌患者的特征性菌属。具核梭杆菌（Fusobacterium nucleatum）、龋齿放线菌（Actinomyces odontolyticus）和口炎消化链球菌（Peptostreptococcus stomatis）或分别为黄腻苔和白腻苔结直肠癌患者潜在的口-肠相关菌。结论：结直肠癌患者舌苔变化与舌苔、肠道菌群结构和丰度的变化相关，舌苔菌群与癌组织菌群、癌旁组织菌群不同的重叠种类及程度提示中医舌诊腻苔的变化能反映出结直肠癌口-肠菌群的特征性变化，为后期研究中药靶向微生物干预结直肠癌的发展提供客观依据。

Correlations of Tongue Coating Changes with Tongue Coating Microbiota and Gut Microbiota in Patients with Colorectal Cancer

To explore the correlations of tongue coating changes with and tongue coating microbiota and gut microbiota in the patients with greasy tongue coating and colorectal cancer.Methods:A total of 63 patients with colorectal cancer treated in the Department of Colorectal Surgery of the First Affiliated Hospital of Harbin Medical University from September 2022 to March 2023 were enrolled in this study.Based on the characteristics of tongue coatings，12 patients with yellow greasy tongue coating and 9 patients with white greasy tongue coating were selected by stratified random sampling，and the tongue coating，cancer tissue，and adjacent tissue were sampled from these patients.Meanwhile，tongue coating samples were collected from 6 healthy volunteers with thin white tongue coating and no abnormalities during colonoscopy as the control group.All the samples were subjected to high-throughput 5R 16S rDNA sequencing.Results:The patients with colorectal cancer mainly presented yellow greasy tongue coating and white greasy tongue coating.Atopobium in the tongue coating and Granulicatella in the gut might be characteristic bacteria in the patients with yellow greasy tongue coating.Gemella in the tongue coating and Roseburia and Shewanella in the gut might be characteristic bacterial genera in the patients with white greasy tongue coating.Fusobacterium nucleatum，Actinomyces odontolyticus，and Peptostreptococcus stomatis might be potential oral and intestinal bacteria in the colorectal cancer patients with yellow greasy tongue coating and white greasy tongue coating，respectively.Conclusion:The changes of tongue coating in colorectal cancer patients are related to the changes of the structure and abundance of gut microbiota and tongue coating microbiota.The different overlapping species and degrees between tongue coating microbiota，cancer tissue microbiota，and adjacent tissue microbiota suggest that the changes in greasy tongue coating in traditional Chinese medicine can reflect the characteristic changes in the oral and intestinal microbiota in the patients with colorectal cancer.The findings provide a theoretical basis for the later research on the Chinese medicines for colorectal cancer by targeting microorganisms.