抗生素与5-氟尿嘧啶治疗结直肠癌患者肿瘤转移的关系

Association of antibiotics with tumor metastasis in colorectal cancer patients undergoing 5-fluorouracil treatment

摘要

目的 分析重庆地区抗生素治疗对接受5-氟尿嘧啶（5-fluorouracil，5-FU）治疗的结直肠癌（colorectal cancer，CRC）患者肿瘤转移的影响，以期为抗生素在抗癌过程中的使用提供新的见解和策略。 方法 回顾性收集2012年1月1日至2021年12月31日重庆市七家医院489例接受5-FU治疗的CRC患者的电子病历资料，采用单因素和多因素logistic回归分析抗生素治疗与接受5-FU治疗的CRC患者肿瘤转移的关系。 结果 在接受5-FU治疗的CRC患者和接受5-FU治疗未感染的CRC患者中，接受抗生素治疗的患者的肿瘤转移风险降低（OR=0.410，95%CI=0.201~0.857，P<0.001；OR=0.277，95%CI=0.129~0.607，P=0.001）。使用青霉素的CRC患者的肿瘤转移可能性高于单独使用头孢的患者。 结论 抗生素治疗是影响CRC患者肿瘤转移的保护因素，青霉素在抗癌过程的使用可能存在潜在风险，临床医生应谨慎考虑青霉素在5-FU治疗过程中的使用。

Abstract

Objective To analyze the influence of antibiotic therapy on tumor metastasis in patients with colorectal cancer（CRC） in Chongqing，who had undergone 5-fluorouracil（5-FU） treatment，aiming to provide novel insights and strategies regarding antibiotic usage in anticancer treatment. Methods The electronic medical records of 489 patients with CRC who underwent 5-FU treatment in seven hospitals in Chongqing from January 1，2012 to December 31，2021 were retrospectively collected. Both univariate and multivariate logistic regression analyses were utilized to discern the association between antibiotic treatment and tumor metastasis in patients with CRC who underwent 5-FU treatment. Results In patients with CRC who underwent 5-FU treatment and those who underwent 5-FU treatment without being infected，the risk for tumor metastasis was reduced in patients receiving antibiotic treatment（odds ratio ［OR］=0.410，95%CI=0.201-0.857，P<0.001；OR=0.277，95%CI=0.129-0.607，P=0.001）. The possibility of tumor metastasis was higher in patients with CRC undergoing penicillin treatment than in those receiving cephalosporins treatment alone（P<0.05）. Conclusion Antibiotic treatment is a protective factor against tumor metastasis in patients with CRC. Penicillin usage during anticancer treatment may introduce potential risks. Clinicians should exercise caution when prescribing penicillin in conjunction with 5-FU treatment.

关键词

抗生素 / 风险因素 / 5-氟尿嘧啶治疗 / 结直肠癌 / 肿瘤转移

Key words

antibiotics / risk factor / 5-fluorouracil treatment / colorectal cancer / tumor metastasis

基金资助

重庆医科大学智慧医学研究资助项目(ZHYX202106)