肠道菌群或可预测结直肠癌术后进展？

Microbiome[IF:16.837]

① 纳入333名原发性结直肠癌（CRC）患者，术前两周内收集粪便，发现肠菌组成与临床病理阶段、CRC进展和死亡有关；

② 普氏菌丰度较高患者CRC进展和死亡风险较低，具核梭杆菌、Bacteroides sp.和Dialister invisus等四种机会致病菌与疾病进展和死亡高风险有关；

③ 依据5种预后细菌的微生物危险评分划分为3个等级，可准确预测CRC进展且优于现有临床标记物；

④ 发现9条有益和6条有害代谢通路，其中二磷酸硫胺回收II和L-组氨酸降解I与预后显著相关。

Enterotypical Prevotella and three novel bacterial biomarkers in preoperative stool predict the clinical outcome of colorectal cancer
11-28, doi: 10.1186/s40168-022-01388-8

【主编评语】大肠癌，又称结直肠癌（CRC），是指大肠上皮来源的癌症，包括结肠癌与直肠癌，病理类型以腺癌最为常见，极少数为鳞癌。约30%的I-III期CRC患者在肿瘤切除后5年内复发，因此，对手术后的进展风险进行分层，识别潜在的临床生物标记物对于CRC患者预后十分重要。近日，韩国延世大学研究人员在Microbiome发表最新研究，纳入333名原发性结直肠癌（CRC）患者，术前两周内收集粪便，发现普氏菌肠型和四个机会性致病菌与CRC进展和死亡风险有关，可以作为标记物较好的预测CRC进展，值得关注。

Enterotypical Prevotella and three novel bacterial biomarkers in preoperative stool predict the clinical outcome of colorectal cancer

术前粪便中肠道典型普雷沃氏菌和三种新型细菌生物标志物可预测结直肠癌的临床预后

10.1186/s40168-022-01388-8

11-28, Article

Abstract:

Background: A significant proportion of colorectal cancer (CRC) patients suffer from early recurrence and progression after surgical treatment. Although the gut microbiota is considered as a key player in the initiation and progression of CRC, most prospective studies have been focused on a particular pathobionts such as Fusobacterium nucleatum. Here, we aimed to identify novel prognostic bacteria for CRC by examining the preoperative gut microbiota through 16S ribosomal RNA gene sequencing.

Results: We collected stool samples from 333 patients with primary CRC within 2 weeks before surgery and followed up the patients for a median of 27.6 months for progression and 43.6 months for survival. The sequence and prognosis data were assessed using the log-rank test and multivariate Cox proportional hazard analysis. The gut microbiota was associated with the clinical outcomes of CRC patients (Pprogress = 0.011, Pdecease = 0.007). In particular, the high abundance of Prevotella, a representative genus of human enterotypes, indicated lower risks of CRC progression (P = 0.026) and decease (P = 0.0056), while the occurrence of Alistipes assigned to Bacteroides sp., Pyramidobacter piscolens, Dialister invisus, and Fusobacterium nucleatum indicated a high risk of progression. A microbiota-derived hazard score considering the five prognostic bacteria accurately predicted CRC progression in 1000 random subsamples; it outperformed widely accepted clinical biomarkers such as carcinoembryonic antigen and lymphatic invasion, after adjustment for the clinicopathological stage (adjusted HR 2.07 [95% CI, 1.61–2.64], P = 7.8e−9, C-index = 0.78). PICRUSt2 suggested that microbial pathways pertaining to thiamine salvage and L-histidine degradation underlie the different prognoses.

Conclusions: The enterotypical genus Prevotella was demonstrated to be useful in improving CRC prognosis, and combined with the four pathobionts, our hazard score based on the gut microbiota should provide an important asset in predicting medical outcomes for CRC patients.

First Authors:
Ji-Won Huh

Correspondence Authors:
Jihyun F Kim,Ji Won Park

All Authors:
Ji-Won Huh,Min Jung Kim,Jaesik Kim,Hyeon Gwon Lee,Seung-Bum Ryoo,Ja-Lok Ku,Seung-Yong Jeong,Kyu Joo Park,Dokyoon Kim,Jihyun F Kim,Ji Won Park