基底细胞癌患者皮肤菌群特征分析

杨 云　吴 雨

[关键词]基底细胞癌;倾向性评分;皮肤微生物菌群;菌群特征;菌群丰度;菌群多样性

[中图分类号]R739.5    [文献标志码]A    [文章编号]1008-6455（2021）12-0098-04

Analysis of Characteristics of Skin Flora in Patients with Basal Cell Carcinoma

YANG Yun，WU Yu

（Department of Dermatology，the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture，Enshi 445000，Hubei，China ）

Abstract： Objective  To analyze the characteristics of skin flora of patients with basal cell carcinoma（BCC）. Methods  The 63 patients with BCC who were admitted to the author’s hospital from January 2016 to December 2019 were taken as the BCC group， and 138 routine patients received during the same period were included as the control group. The two groups of patients were matched with propensity scores， and the general clinical data and skin microbial flora of the two groups were compared， and the correlation between skin flora characteristics and BCC was analyzed. Results  After matching of propensity scores， the two groups of patients were successfully matched with 53 groups. After matching， the general data of the two groups were compared， and the difference was not statistically significant （P>0.05）， the diversity of skin flora in the BCC group was lower than that of the control group， and the difference was statistically significant Significance （P<0.05）. The PCA results showed that the two groups could be distinguished significantly. LEfse multi-level species difference discriminant analysis showed that at the genus level， the control group and the BCC group had 4 bacterial genera with higher abundance; in the control group， streptococcus， Fusobacterium， Haemophilus and Prevotella The abundance is higher; in the BBC group， Campylobacter， Pasteurella， Prevotella and Neisseria have higher abundance. Conclusion  Analysis of the characteristics of the skin flora of BCC showed that Campylobacter， Pasteurella， Prevotella and Neisseria are relatively abundant， which may be related to the occurrence of BCC.

Key words： basal cell carcinoma; propensity score; skin microbial flora; flora characteristics; bacteria abundance; flora diversity;

基底細胞癌（Basal cell carcinoma，BCC）是一种最常见的局部皮肤恶性肿瘤，主要分为侵袭性和非侵袭性两种亚型，多发生于40岁以上的中老年人[1]。其生长速度缓慢，有较强局部破坏力，但预后良好[2]。紫外线及PTCH基因改变等是最重要的病因[3]。具体发病机制不清，但与机体的免疫细胞有密切关系[4]。微生物菌群和人类细胞中均可分泌一种GDP-L-海藻糖合酶，能与机体内的T细胞发生反应，诱发机体的免疫反应[5]。目前有学者对BCC患者进行遗传特性分析后发现，皮肤上特定的微生物菌群可分泌GDP-L-海藻糖合酶，能激活皮肤上的免疫细胞并将其迁移至大脑中并诱发炎性级联反应，这一反应在BCC的病理过程中扮演了关键角色[6]。但目前国内针对基底细胞癌与皮肤微生物菌群的相关研究较少。本研究通过观察皮肤BCC的病理分型与皮肤菌群之间的关系，并进行了多样性分析。现将研究结果报道如下。

1  资料和方法

1.1 一般资料：选取2016年1月-2019年12月于笔者医院接诊的63例BCC患者作为BCC组，并纳入同期接诊的138例常规患者作为对照组。本研究经医院伦理委员会审查后批准通过，经患者和家属同意后签署知情同意书。纳入标准：①所有患者均为符合基底细胞癌的诊断[7]，并已进行皮肤组织病理活检;②年龄在18～80岁之间;③能配合整个研究过程;④近期未服用过干扰菌群的药物。排除标准：①合并有湿疹、过敏等其他皮肤疾病者;②不能耐受皮肤菌群活检者;③合并有急性心肌梗死、急性脑梗死、血液疾病或恶性肿瘤等疾病;④精神异常不能配合研究者;⑤患有严重的心、肝、肾功能不全。……