To explore the effects of anti-programmed death-1 (PD-1) therapy on advanced colorectal cancer (CRC) based on the intestinal microecology. Ninety-two patients with advanced CRC were selected. Patients were treated with Apatinib alone or anti PD-1 treatment combined with Apatinib. The lactulose/mannitol (L/M) value of the urine was detected by high performance liquid chromatography. The changes of intestinal microflora were determined by real-time fluorescence quantitative PCR. The risk factors were analyzed through multivariate logistic regression analysis. The curative effect of anti PD-1 treatment combined with the Apatinib treatment (82.61%) was much higher than that of the Apatinib treatment alone (63.04%, p < 0.05). After treatment, the contents of Bifidobacterium, Lactobacillus, and Enterococcus faecalis were higher with lower levels of Escherichia coli in the observation group than the control (p < 0.05). The level of D-lactic acid and urinary L/M value of the urine in the observation group was lower than that in control after treatment (p < 0.001). The patients had a 3-year survival rate of 91.30%. Age >60 years old, histological types of mucinous adenocarcinoma and signet ring cell carcinoma, vascular tumor thrombus, nerve invasion, TNM stage of Ⅲ-Ⅳ were independent risk factors, and anti PD-1 treatment was the protective factor (p < 0.05). In advanced CRC patients receiving anti PD-1 treatment combined with the Apatinib treatment, the progression of advanced CRC was effectively controlled by maintaining the intestinal microflora balance. Anti PD-1 therapy can improve the living quality of CRC patients.
Keywords: anti-PD-1; colorectal cancer; intestinal microflora; survival.
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