作者：黄健1,2，钟清连1,2

单位：1.中山大学附属第八医院 消化内科，广东 深圳 518033； 2.中山大学▪深圳，广东 深圳 518033

Authors: Huang Jian1,2，Zhong Qinglian1,2

Unit: 1.Department of Gastroenterology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China； 2.Sun Yat-sen University▪Shenzhen, Shenzhen, Guangdong 518033, China

摘要：

目的 探讨血浆氧化三甲胺(triethylamine-N-oxide,TMAO)与结直肠肿瘤性疾病的关系。方法 分析2016年8月至2019年8月于中山大学附属第八医院消化内科就诊的120例结肠腺瘤患者,138例结直肠癌患者和138例健康体检对照者。患者均接受了结肠镜检查,检测并比较各组空腹血浆TMAO及其前提物质胆碱、甜菜碱、肉碱、左旋肉碱等水平,分别评价上述物质与结直肠肿瘤性疾病发生的相关性。结果 TMAO的升高与结肠腺瘤及结直肠癌的发生中具有相关性(P<0.05),其中与结直肠腺瘤的相关性更为密切(r=0.744,P<0.05)。TMAO前体物质胆碱在结直肠癌组及结肠腺瘤组的水平均有升高(P<0.01,P<0.05),但与两者的发生无相关性(P>0.05)。在结直肠癌组中,TMAO的水平在年龄大于45岁患者或病灶大于3 cm的患者中的升高具有统计学意义(P<0.01)。结论 血浆TMAO的水平与结直肠肿瘤性疾病的发生具有相关性。

关键词：氧化三甲胺; 结直肠癌; 结直肠腺瘤; 肠道菌群

Abstract：

Objective To investigate the relationship between plasma triethylamine-N-oxide (TMAO) and colorectal neoplasms disease. Methods From August 2016 to August 2019, 120 patients with colon adenoma, 138 patients with colorectal cancer and 138 healthy controls were analyzed in the Gastroenterology Department of the Eighth Affiliated Hospital of Sun Yat-sen University. All patients underwent colonoscopy. The fasting plasma levels of TMAO and its prerequisite substances choline, betaine, carnitine, and L-carnitine were tested and compared in each group to evaluate the correlation between these substances and the occurrence of colorectal neoplastic diseases. Results The increase of TMAO was correlated with the occurrenceof colon adenoma and colorectal cancer (P<0.05). Among them, the correlation with colorectal adenoma is more closely (P<0.05), and the correlation coefficient is 0.744. The level of TMAO precursor choline was increased in the colorectal cancer group and colon adenoma group (P<0.01, P<0.05), but there was no correlation with the occurrence of the two(P>0.05). In the colorectal cancer group, the increase in TMAO levels in patients older than 45 years old or patients with lesions larger than 3 cm was statistically significant (P<0.01). Conclusion The level of plasma TMAO is correlated with the occurrence of colorectal neoplastic diseases.

Key Words: Trimethylamine-N-oxide; Colorectal cancer; Colorectal adenomas; Gut microbiome