Exploring The Influence Of Pien Tze Huang On Enhanced Recovery After Surgery Of Non-small Cell Lung Cancer Based On Microecology Of Lung Cancer

ObjectiveThe aim of this study is to use metagenomics next-generation sequencing（m NGS）technology to analyze the microecological characteristics of lung tissues in early stage non-small cell lung cancer（NSCLC）patients,and to explore the effect of Pien Tze Huang on the microecology of lung cancer and enhanced recovery after surgery of early stage NSCLC patients,so as to provide new ideas for the enhanced recovery after surgery of early stage NSCLC.MethodsA total of 15 cases of early stage NSCLC were included in the study,including 5 cases in the Pien Tze Huang intervention group and 10 cases in the blank control group.All lung tissue samples were tested for microbial information by m NGS.Alpha diversity,Beta diversity,community cluster analysis and specific microbial analysis were performed.Enhanced recovery after surgery indicators included the indwelling time of chest drainage tube,the pain score,the lung cancer symptom score,the six-minute walk test（6MWT）and the laboratory indicators（including white blood cell count,neutrophil count and so on）.T-test,Mann-Whitney U test,chi-square test or Fisher’s exact probability method were used for analysis.ResultsThe microbiome of lung tissue in early NSCLC was dominated by bacteria（91%）,followed by fungi（9%）.At the species level,the dominant bacteria were Yarrowia lipolytica,Pseudomonas alcaliphila,Mycobacterium kansasii,Acinetobacter johnsonii（relative abundance was 22.65%,12.05%,5.06%and 4.82%,respectively）.The microbiome of lung tissue was changed after the intervention of Pien Tze Huang:Methylobacterium radiotolerans and Janibacter indicus were the dominant bacteria in the Pien Tze Huang intervention group（relative abundance was 65.99%and 2.53%,respectively）.The Pien Tze Huang intervention group had higher diversity than the blank control group（Richness index:8.20±5.50 vs3.44±1.51,Shannon index:1.38±0.64 vs 1.03±0.53,Simpson index:0.62±0.28 vs 0.56±0.26,Inverse Simpson index:4.22±3.11 vs 2.94±1.46）,and there was a significant difference in the structure of the microbiota between the two groups（P<0.05）.Janibacter indicus,Mammaliicoccus lentus,Kluyvera intermedia and Acinetobacter beijerinckii were the differential microorganisms between the two groups and were significantly enriched in the Pien Tze Huang intervention group.In terms of clinical efficacy,the duration of drainage tube indwelling in the Pien Tze Huang intervention group was shorter than that in the blank control group（3 days vs 5 days,P<0.05）.The pain score of the Pien Tze Huang intervention group was better than that of the blank control group on the 3^rd and 7^th day after surgery（2.0±0.71 vs3.9±1.60,P<0.05;0.8±0.84 vs 2.7±1.25,P<0.05）.The lung cancer symptom score of the Pien Tze Huang intervention group was better than that of the blank control group on the 7^thday after surgery（4.80±2.17 vs 8.60±3.47,P<0.05）.The 6MWT of the Pien Tze Huang intervention group was slightly better than that of the blank control group on the 7th day after surgery（570（504.5,553.0）vs 564.5（499.8,524.0））,however,the difference was not statistically significant.The white blood cell count in the Pien Tze Huang intervention group were lower than those in the blank control group on the 1^st day after operation（11.32±3.35 vs14.27±1.48,P<0.05）,and the granulocyte count in the Pien Tze Huang intervention group were lower than those in the blank control group on the 3^rd day after operation（5.97（3.10,7.32）vs 9.04（8.37,10.00）,P<0.05）.ConclusionThere is structural imbalance in the microbiome of lung tissue in early stage NSCLC.Pien Tze Huang may affect the microbiome of lung tissue in early stage NSCLC and may have a positive effect on promoting the enhanced recovery of patients after surgery.