42例口腔鳞癌患者口腔粘膜和唾液菌群分布

目的:探讨口腔鳞癌对口腔菌群的影响。方法:42例口腔鳞癌患者常规联合根治术后给予头孢噻肟钠、奈替米星抗感染2周,分别检测其手术前后唾液、病变区粘膜或术区粘膜、正常粘膜可培养细菌的数量、构成比和检出率。结果:术前唾液细菌量(x=8110@108CFU/ml,lgx=819084)明显高于术后,术前病变区粘膜细菌量(x=5121@ 105CFU/cm2,lgx=517169)远高于对侧正常粘膜,优势菌群发生改变,病变区粘膜有外籍菌定植(白色念珠菌、绿脓杆菌)。术后切口区粘膜细菌量(x=4134@105CFU/cm2,lgx=516372)仍远高于对侧正常粘膜(x=7124@104CFU/ cm2,lgx=418599),链球菌属所占比例成倍增加。结论:口腔鳞癌可导致患者口腔菌群失调,增加感染的危险性及继发局部或全身感染。

Oral Microflora of 42 Patients with Oral Squamous Cell Carcinoma

OBJECTIVE: The purpose of this study was to evaluate the effects of squamous cell carcinoma on oral bacteria. METHODS: This study investigated the microbial contents of the plaque on the surfaces of oral squamous cell carcinomas. Samples were obtained from the central surface of lesions, contiguous healthy mucosa and saliva of 42 patients with oral squamous carcinoma before and after operation. RESULTS: The median of bacterial colony forming units per milliliter (CFUs/ml) of saliva before operation was 8.10 x 10(8) CFUs/ml. The median of CFUs per square centimeter of the tumor surface was 5.21 x 10(5) CFUs/cm2 which was significantly higher than that of the healthy (the control) mucosa (1.77 x 10(4) CFUs/cm2, P = 0.0001). The CFUs per square centimeter of mucosa surface at the operative zone was 4.34 x 10(5) CFUs/cm2 which was also significantly higher than that of the healthy (control) mucosa(7.24 x 10(4) CFUs/cm2, P = 0.0001). CONCLUSION: Oral carcinoma can break the balance of oral microflora, which may be one of the reasons leading to the high susceptivity of these compromised patients to systemic infection.