Profile of Gut Microbiota Associated With the Presence of Hepatocellular Cancer in Patients With Liver Cirrhosis
Profile of Gut Microbiota Associated With the Presence of Hepatocellular Cancer in Patients With Liver Cirrhosis
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DOI：
10.1016/j.transproceed.2016.01.077
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发表时间：
2016-06-01
影响因子：
0.9
通讯作者：
Krawczyk, M.
中科院分区：
文献类型：
--
作者：
Grat, M.;Wronka, K. M.;Krawczyk, M.
背景肠道微生物群的变化有助于慢性肝病的进展。根据在动物模型中进行的几项研究的结果，肠道生态失调在肝癌发生中起着重要作用。本研究的目的是探讨肝硬化患者接受肝移植后与肝细胞癌（HCC）相关的肠道菌群特征。根据肝硬化病因和终末期肝病模型（MELD）评分，共纳入了15例HCC患者和15例非HCC患者，这些患者在2012年至2014年期间接受了肝移植。他们的肠道微生物谱分析是基于移植前前瞻性收集的粪便样本。HCC患者和非HCC患者在年龄（P = 0.506）、性别（P = 0.700）、丙型肝炎病毒（P > 0.999）和B型肝炎病毒（P = 0.715）感染状态、酒精性肝病（P > 0.999）和MELD评分（P = 0.337）方面相似。值得注意的是，肝细胞癌的存在与粪便中大肠杆菌计数的显著增加相关（P = 0.025）。根据大肠杆菌计数预测HCC存在与0.742（95%置信区间，0.564-0.920）的受试者工作曲线下面积相关，最佳截止值为17.728（每克粪便中菌落形成单位的自然对数）。确定临界值的敏感性和特异性分别为66.7%和73.3%。与肝细胞癌相关的肠道菌群特征表现为大肠杆菌粪便计数增加。因此，大肠杆菌肠道过度生长可能有助于肝癌的发生。
Background. Changes within the gut microbiota contribute to the progression of chronic liver diseases. According to the results of several studies performed in animal models, gut dysbiosis plays an important role in hepatocarcinogenesis. The aim of this study was to explore the characteristics of gut microbiota associated with the presence of hepatocellular cancer (HCC) in patients with cirrhosis of the liver undergoing liver transplantation.Methods. A total of 15 patients with HCC and 15 non-HCC patients matched according to etiology of cirrhosis and Model for End-Stage Liver Disease (MELD) scores who underwent liver transplantations between 2012 and 2014 were included. Analysis of their gut microbial profile was based on prospectively collected stool samples from the pretransplant period.Results. Patients with and without HCC were similar with respect to age (P = .506), sex (P = .700), hepatitis C virus (P > .999) and hepatitis B virus (P = .715) infection status, alcoholic liver disease (P > .999), and MELD score (P = .337). Notably, the presence of HCC was associated with significantly increased fecal counts of Escherichia coli (P = .025). Prediction of HCC presence based on E coli counts was associated with the area under the receiver-operating curve of 0.742 (95% confidence interval, 0.564-0.920), with the optimal cutoff on the level of 17.728 (natural logarithm of colony-forming units per 1 g of feces). Sensitivity and specificity rates for the established cutoff were 66.7% and 73.3%, respectively.Conclusions. The profile of gut microbiota associated with the presence of HCC in cirrhotic patients is characterized by increased fecal counts of E coli. Therefore, intestinal overgrowth of E coli may contribute to the process of hepatocarcinogenesis.