| Background and Objective:Cachexia is a common complication of patients with various advanced tumors,which seriously affects the quality of life and shorten the survival time of the patients.Patients with advanced tumors and cachexia often adopt palliative treatment,mainly from the aspects of relieving clinical symptoms and improving quality of life.On the premise of monitoring vital signs and maintaining stable internal environment,they can improve the nutritional status of patients,increase the therapeutic effect and prolong their lives.After multiple anti-tumor treatments,the intestinal flora of patients with advanced stage is often in an imbalance state.The microbial flora affects the occurrence and development of cachexia through systemic inflammation,intestinal barrier dysfunction,muscle atrophy and other ways.In recent years,more and more researchers have chosen to improve the intestinal micro-ecological environment through fecal microbiota transplantation(FMT).In this study,patients with advanced tumors and cachexia were selected to transplant the intestinal flora of healthy adults on the basis of standardized nutritional therapy.To explain whether the nutritional status and quality of life of patients with advanced tumors can be improved by FMT,and to explore whether it can regulate the immune function and intestinal microbial composition of patients with advanced tumors.Materials and methods:From October 2020 to June 2021,20 patients with advanced tumors and cachexia were admitted to our hospital.According to the principle of tendentiousness score,all subjects were divided into the experimental group(standard nutrition group with FMT)with 10 cases and the control group(standard nutrition group)with 10 cases.The control group was given standardized nutritional therapy,and the experimental group was transplanted with healthy adult intestinal flora on the basis of standardized nutritional therapy.The quality of life of patients was evaluated using the European Organization for Research and Treatment of Cancer’s core quality of life scale-EORTIC QLQ-C30(version 3).Take peripheral blood samples before and after FMT,and use flow cytometry to quantitatively detect 13 key targets:IL-1β,IL-2,IL-4,IL-6,IL-10,IL-12p70,IL-17a,TNF-α,TGF-β1,IFN-γ,CXCL10(IP-10),CCL2(MCP-1),CXCL8(IL-8).The fecal samples of patients before and after transplantation were analyzed by 16S r RNA gene sequencing and macro genome sequencing.Result:(1)Compared with the control group,the hemoglobin,albumin and prealbumin in the experimental group increased after transplantation(P<0.05).The skeletal muscle and protein of the experimental group after transplantation were significantly different from those before transplantation(P<0.05).There were statistical differences in the field of nausea and vomiting,overall health status and economic field before and after transplantation(P<0.05).(2)IL-2,IL-10,TNF-α,IFN-γof patients in experimental group after transplantation compared with the experimental group before transplantation,it was significantly higher(P<0.05),no difference was found in the remaining indicators.And the changes of CD4~+and CD8~+T cells before and after transplantation were statistically significant(P<0.05).(3)The results of 16S r RNA gene sequencing and macro genome sequencing showed that the composition of fecal microflora of patients in the experimental group changed significantly after FMT.Conclusion:1.Fecal microbiota transplantation improved the nutritional indicators of patients with cachexia.There were significant differences in hemoglobin,albumin,prealbumin,protein,skeletal muscle after transplantation.2.Fecal microbiota transplantation regulated the immune function of patients with cachexia.After transplantation,the levels of IL-2,IL-10,IFN-γand TNF-αwere significantly higher than those before transplantation,and the activation of CD4~+and CD8~+T cells was increased.3.The microbial species of intestinal flora in patients with cachexia changed significantly before and after microbiota transplantation. |
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