Intestinal microbiota characteristics and dietary fiber intervention in patients undergoing endoscopic mucosa resection

Table 1 Baseline characteristics of study participants, n (%)

Characteristic	Total (n = 86)	Intervention group (n = 43)	Control group (n = 43)	P value
Age (years), mean ± SD	52.3 ± 8.6	51.7 ± 8.2	53.0 ± 8.9	0.468
Gender	-	-	-	0.752
Male	50 (58.1)	25 (58.1)	25 (58.1)	0.752
Female	36 (41.9)	18 (41.9)	18 (41.9)	0.752
Tumor location	-	-	-	0.861
Stomach	54 (62.8)	27 (62.8)	27 (62.8)	0.861
Esophagus	20 (23.3)	10 (23.3)	10 (23.3)	0.861
Colorectum	12 (13.9)	6 (13.9)	6 (13.9)	0.861
Tumor size (cm)	2.5 ± 1.2	2.4 ± 1.1	2.6 ± 1.3	0.532
Pathological type	-	-	-	0.695
Adenoma	62 (72.1)	31 (72.1)	31 (72.1)	0.695
Early cancer	24 (27.9)	12 (27.9)	12 (27.9)	0.695
Surgery duration (minutes), mean ± SD	45.6 ± 12.3	44.8 ± 11.7	46.4 ± 12.9	0.486
Anesthesia method	-	-	-	0.921
Local anesthesia	52 (60.5)	26 (60.5)	26 (60.5)	0.921
General anesthesia	34 (39.5)	17 (39.5)	17 (39.5)	0.921

Table 2 Dynamic changes in intestinal microbiota diversity following endoscopic mucosa resection, mean ± SD

Microbiota diversity indicators	Control group	Intervention group	P value
Baseline
Shannon diversity index	4.52 ± 0.33	4.52 ± 0.33	0.990
Bacterial species richness	245 ± 32	246 ± 33	0.985
Simpson index	0.85 ± 0.07	0.85 ± 0.07	0.995
Firmicutes/bacteroidetes ratio	1.20 ± 0.20	1.20 ± 0.20	0.995
Microbial stability score	1.00	1.00	-
Alpha diversity (observed species)	250 ± 35	250 ± 35	0.990
Chao1 richness estimator	260 ± 40	260 ± 40	0.990
ACE richness estimator	270 ± 45	270 ± 45	0.990
PD whole tree (phylogenetic diversity)	0.75 ± 0.08	0.75 ± 0.08	0.990
2 weeks post-surgery
Shannon diversity index	2.87 ± 0.25	3.76 ± 0.28	< 0.01
Bacterial species richness	178 ± 26	225 ± 30	< 0.01
Simpson index	0.60 ± 0.06	0.75 ± 0.06	< 0.01
Firmicutes/bacteroidetes ratio	0.80 ± 0.15	1.00 ± 0.18	< 0.01
Microbial stability score	0.62 ± 0.08	0.75 ± 0.07	< 0.01
Alpha diversity (observed species)	180 ± 25	230 ± 30	< 0.01
Chao1 richness estimator	190 ± 30	240 ± 35	< 0.01
ACE richness estimator	200 ± 35	250 ± 40	< 0.01
PD whole tree (phylogenetic diversity)	0.55 ± 0.07	0.65 ± 0.07	< 0.01
4 weeks post-surgery
Shannon diversity index	3.24 ± 0.31	4.41 ± 0.32	< 0.01
Bacterial species richness	203 ± 29	242 ± 31	< 0.01
Simpson index	0.70 ± 0.07	0.84 ± 0.07	< 0.01
Firmicutes/bacteroidetes ratio	0.90 ± 0.16	1.10 ± 0.20	< 0.01
Microbial stability score	0.95 ± 0.06	0.98 ± 0.05	< 0.01
Alpha diversity (observed species)	210 ± 30	245 ± 32	< 0.01
Chao1 richness estimator	220 ± 35	255 ± 38	< 0.01
ACE richness estimator	230 ± 40	265 ± 42	< 0.01
PD whole tree (phylogenetic diversity)	0.65 ± 0.08	0.72 ± 0.08	< 0.01

ACE: Abundance-based coverage estimator; PD: Phylogenetic diversity.

Table 3 Molecular transformation of microbiota structure and functional genes, mean ± SD

Microbiota composition and gene expression indicators	Control group	Intervention group	P value
Beneficial bacterial populations
Lactobacilli abundance (%)	12.4 ± 2.1	18.6 ± 2.3	< 0.01
Bifidobacteria abundance (%)	8.7 ± 1.5	15.3 ± 1.8	< 0.01
Pathogenic bacterial populations
Gram-negative bacteria (%)	42.6 ± 3.2	28.4 ± 2.7	< 0.01
Conditional pathogenic bacteria (%)	24.3 ± 2.5	15.6 ± 2.1	< 0.01
Intestinal barrier-related gene expression
Tight junction proteins	0.68 ± 0.12	1.42 ± 0.16	< 0.01
Defensin genes	0.52 ± 0.09	1.27 ± 0.14	< 0.01
Microbial diversity indices
Microbial diversity index	0.36 ± 0.05	0.82 ± 0.07	< 0.01
Functional gene diversity	124 ± 18	212 ± 25	< 0.01
Metabolic function genes
Short-chain fatty acid production genes	36.5 ± 4.2	58.7 ± 5.1	< 0.01

Table 4 Systemic inflammatory response patterns post-endoscopic mucosa resection, mean ± SD

Inflammatory markers and response indices	Control group	Intervention group	P value
IL-6 (pg/mL)
Baseline	12.4 ± 2.1	12.3 ± 2.2	0.892
Peak value	28.6 ± 4.3	16.5 ± 3.1	< 0.01
TNF-α (pg/mL)
Baseline	8.7 ± 1.5	8.6 ± 1.4	0.875
Peak value	22.3 ± 3.6	14.2 ± 2.8	< 0.01
C-reactive protein (mg/L)
Baseline	3.2 ± 0.7	3.1 ± 0.6	0.784
Peak value	15.2 ± 3.4	9.7 ± 2.6	< 0.01
Inflammatory response indices
Inflammatory peak time (weeks)	2.0 ± 0.3	1.2 ± 0.2	< 0.01
Inflammatory range	0.76 ± 0.12	0.42 ± 0.09	< 0.01
Pro-inflammatory cytokines
Total pro-inflammatory cytokines	48.5 ± 6.2	32.7 ± 5.1	< 0.01
Anti-inflammatory cytokines	18.3 ± 3.1	26.4 ± 4.2	< 0.01
Inflammatory recovery time (days)	12.6 ± 2.1	7.8 ± 1.5	< 0.01

IL: Interleukin; TNF-α: Tumor necrosis factor-α.

Table 5 Multidimensional analysis of patient quality of life, n (%)

Recovery and complication indicators	Control group (n = 43)	Intervention group (n = 43)	P value
Hospital stay (days), mean ± SD	10.5 ± 2.3	7.8 ± 1.6	< 0.05
Total complications	8 (18.6)	2 (4.7)	< 0.01
Specific complications
Local infections	4 (9.3)	1 (2.3)	0.042
Delayed wound healing	3 (7.0)	1 (2.3)	0.126
Other minor complications	1 (2.3)	0 (0)	0.315
Recovery time indicators, mean ± SD
Postoperative fever duration (days)	3.2 ± 1.1	1.7 ± 0.8	< 0.01
Pain resolution time (days)	4.6 ± 1.3	2.9 ± 0.9	< 0.01
Oral intake recovery time (days)	3.8 ± 1.2	2.5 ± 0.7	< 0.01
Postoperative functional recovery, mean ± SD
Gastrointestinal function recovery score	68.4 ± 6.2	82.7 ± 5.8	< 0.01
Immune function recovery index	0.42 ± 0.07	0.76 ± 0.11	< 0.01
Patient satisfaction rate	76.7% (33/43)	93.0% (40/43)	< 0.01

Table 6 Long-term microecological and immunological follow-up tracking, mean ± SD

Long-term follow-up indicators	Control group (n = 43)	Intervention group (n = 43)	P value
Recurrence rate, n (%)	4 (9.3)	1 (2.3)	0.042
Microbiota stability indicators
Shannon diversity index	3.62 ± 0.41	4.35 ± 0.38	< 0.01
Microbial stability score	0.64 ± 0.12	0.89 ± 0.15	< 0.01
Immune function indicators
NK cell activity (%)	12.4 ± 2.1	18.6 ± 2.5	< 0.01
CD4+ T cell count (cells/μL)	624 ± 86	742 ± 93	< 0.01
CD8+ T cell count (cells/μL)	456 ± 72	528 ± 65	< 0.01
T cell subset ratio (CD4+/CD8+)	1.36 ± 0.22	1.58 ± 0.25	0.02
Inflammatory markers
IL-6 (pg/mL)	15.3 ± 2.7	9.6 ± 1.8	< 0.01
TNF-α (pg/mL)	12.4 ± 2.1	7.8 ± 1.5	< 0.01
Nutritional status
Albumin levels (g/L)	38.2 ± 3.6	41.5 ± 4.1	0.01
Body mass index changes	-0.8 ± 0.3	0.2 ± 0.1	< 0.01
Quality of life score	68.4 ± 6.2	82.7 ± 5.8	< 0.01

NK: Natural killer; IL: Interleukin; TNF-α: Tumor necrosis factor-α.