Bacterial Alterations in Post-Cholecystectomy Patients Are Associated With Colorectal Cancer
Bacterial Alterations in Post-Cholecystectomy Patients Are Associated With Colorectal Cancer
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胆囊切除术后患者的细菌变化与结直肠癌相关
DOI：
10.3389/fonc.2020.01418
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发表时间：
2020-08-12
影响因子：
4.7
通讯作者：
Liu, Yulan
中科院分区：
文献类型：
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作者：
Ren, Xinhua;Xu, Jun;Liu, Yulan
背景：尽管越来越多的证据表明胆囊切除术与结直肠癌（CRC）的患病率之间存在关联，并揭示了肠道微生物群在结直肠癌发病机制中的作用，但仅有少数研究聚焦于胆囊切除术后的微生物变化，且其在结直肠癌发生和进展中的后续作用尚未见报道。因此，我们旨在研究细菌的变化，并试图阐明其临床意义。
方法：招募104名受试者，分为胆囊切除术后患者（PC，n = 52）和健康对照组（HC，n = 52）。为研究细菌在癌变过程中的作用，根据组织病理学，将PC患者进一步分为癌前病变/结直肠癌组（preCA_CRC，患有癌前病变和/或结直肠癌的患者，n = 9）和非癌组（non - CA，无癌前病变和结直肠癌的患者，n = 43）。收集合格的粪便样本进行16S rRNA基因测序，以分析细菌谱。
结果：我们的数据显示，PC患者的细菌微生物群在组成和丰度上有显著变化，表现为卵形拟杆菌、普通拟杆菌和多形梭杆菌显著增加；普拉梭菌、粪罗斯拜瑞氏菌和青春双歧杆菌显著减少。此外，胆囊切除术后的时长是影响细菌组成的关键因素。基于机器学习的分析表明，纺锤巨单胞菌在区分PC患者与HC受试者以及参与结直肠癌进展中起着关键作用。
结论：PC患者的细菌生态失调可能与结直肠癌相关，胆囊切除术后的时长被视为一个重要因素。在PC患者的长期随访中，改变的细菌微生物群可能在相关疾病中发挥关键作用。
Background: Although increasing evidences showed a correlation between cholecystectomy and the prevalence rate of colorectal cancer (CRC), and shed light on gut microbiota in colorectal pathogenesis, only a few studies focused on microbial alterations after cholecystectomy, and its sequent role in carcinogenesis and progression of CRC has not been reported. Thus, we aimed to investigate the bacterial alterations and tried to clarify their clinical significance. Methods: 104 subjects were enrolled and divided into post-cholecystectomy patients (PC, n = 52) and healthy controls (HC, n = 52). To investigate the bacterial role in carcinogenesis, PC patients were further separated into preCA_CRC (patients with precancerous lesions and/or CRC, n = 9) and non-CA (patients without precancerous lesions and CRC, n = 43) based on the histopathology. Qualified stool samples were collected for 16S rRNA gene sequencing to analyze the bacterial profile. Results: Our data showed noteworthy compositional and abundant alterations of bacterial microbiota in PC patients, characterized as Bacteroides ovatus, Prevotella copri, and Fusobacterium varium remarkably increased; Faecalibacterium prausnitzii, Roseburia faecis, and Bifidobacterium adolescentis significantly decreased. Additionally, the duration after cholecystectomy was the critical factor that affected bacterial composition. Machine learning-based analysis showed a pivotal role of Megamonas funiformis in discriminating PC from HC subjects and involving in the progression of CRC. Conclusions: The bacterial dysbiosis may associate with CRC in PC patients, and the duration after cholecystectomy was highlighted as an important factor. Altered bacterial microbiota was likely to play a pivotal role in related-disease in the long-term follow-up of PC patients.