Effect Of Platinum-containing Dual-drug Chemotherapy On Intestinal Flora In Non-small Cell Lung Cancer Patients

Objectives: The intestinal flora is closely related to the occurrence and development of gastrointestinal side effects after chemotherapy and the efficacy of platinum drugs.In this study,polymerase chain reaction-denaturing gradient gel electrophoresis(PCR-DGGE)was used to qualitative analysis the composition of intestinal flora before and after chemotherapy in patients with non-small cell lung cancer.The purpose of this study is providing theoretical help to treat gastrointestinal side effects after chemotherapy and improve the efficacy of platinum drugs chemotherapy and the prognosis of patients.Method: Patients screening and data collection: Total 28 patients were enrolled in this study,who were diagnosed as primary NSCLC by pathology or cytology and treated with platinum-containing dual-drug regimen firstly in the Second Hospital Affiliated to Dalian Medical University from June of 2015 to August of 2016,and the clinical information was collected.1.Fecal collection and DNA extraction of intestinal microflora: Fresh feces were collected before and after the first-cycle chemotherapy and saved in-40? refrigerator.When used,the feces were removed from the fridge,and the intestinal bacterial genome DNA of the collected feces were extracted.The remaining feces were preserved in-80? refrigerator.2.PCR-DGGE: Bacterial 16 S r DNA V3 region Variable sequences were used as specialprimers to amplify DNA samples,then DGGE was performed to investigate the changes of the intestinal flora in NSCLC patients before and after platinum-containing dual-drug chemotherapy.DGGE results were used for analysis,and the obviously different bands were cut out for sequencing and analyzing to identify the bacterial species.3.Result analysis: Quantity One 4.6.2 was used to analyze the diversity of DGGE profiles trips.SPSS 21.0 was used to analyse data.Results:1.Changes of abundance and diversity index of intestinal flora before and after chemotherapy: Compared with the pre-chemotherapy intestinal flora,the diversity index and abundance of microbiota increased after chemotherapy,but the difference was not statistically significant(P>0.05).2.The relationship between intestinal flora and gastrointestinal reaction: We found the relationship between the changes of the abundance and diversity index of intestinal flora before and after chemotherapy and the gastrointestinal reactions after chemotherapy was significant(P<0.05),through using Fisher test.Patients with increased diversity index and abundance after chemotherapy with platinum-containing drugs are more likely to develop gastrointestinal adverse reactions.3.Changes in specific intestinal flora before and after chemotherapy: Different strips of DGGE patterns before and after chemotherapy were cut and sequenced.Sequencing results showed that the quantity of Eubacterium eligens decreasd;the quantity of Blautia obeum,Paraclostridium bifermentans,Clostridiales bacterium increased.Conclusion:1.The diversity index and abundance of microbiota increased after platinum-containing dual-drug chemotherapy,but the difference was not statistically significant in NSCLC patients.2.Patients with increased diversity index and abundance after platinum-containing dual-drug chemotherapy are more likely to develop gastrointestinal adverse reactions in NSCLC.3.The quantity of Eubacterium eligens decreasd;The quantity of Blautia obeum,Paraclostridium bifermentans,Clostridiales bacterium increased after platinum-containing dual-drug chemotherapy in NSCLC patients.