The Potential Effect of Oral Microbiota in the Prediction of Mucositis During Radiotherapy for Nasopharyngeal Carcinoma.
The Potential Effect of Oral Microbiota in the Prediction of Mucositis During Radiotherapy for Nasopharyngeal Carcinoma.
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口腔微生物群在预测鼻咽癌放疗期间粘膜炎的潜在作用
DOI：
10.1016/j.ebiom.2017.02.002
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发表时间：
2017-04
期刊：
影响因子：
11.1
通讯作者：
Zhou HW
中科院分区：
文献类型：
--
作者：
Zhu XX;Yang XJ;Chao YL;Zheng HM;Sheng HF;Liu HY;He Y;Zhou HW
口腔粘膜炎可能是治疗头颈部癌症患者时出现的最严重的并发症。关于口腔微生物群对粘膜炎的发生和发展的影响知之甚少。本研究采用16 S rRNA基因测序技术，对放射治疗期间口腔细菌谱的动态变化以及口腔黏膜炎的严重程度与细菌谱变化的关系进行了研究。我们的研究结果表明，细菌群落结构在放射治疗过程中逐渐改变，与一些革兰氏阴性菌的相对丰度显着增加平行。最终发展为严重粘膜炎的患者在红斑-斑片状粘膜炎阶段具有显著较低的细菌α多样性和较高丰度的放线杆菌。因此，生成了用于预测粘膜炎恶化的随机森林模型，其实现了0.89的高预测准确度（AUC）。鼻咽癌患者口腔微生物群变化与放疗诱导的粘膜炎进展和加重相关。基于微生物群的策略可用于早期预测和预防放射治疗期间严重粘膜炎的发生。NPC患者口腔菌群与健康人不同。口腔微生物群的生物多样性在放疗期间随着粘膜炎的进展而显著改变。口腔微生物群是预测放射治疗期间严重粘膜炎恶化的潜在策略。口腔或口咽粘膜炎是头颈部癌症放射治疗最常见的副作用。在这项前瞻性队列研究中，我们发现口腔微生物群落的变化与鼻咽癌患者放疗诱导的粘膜炎的进展和加重相关;最终短暂发生严重粘膜炎的患者在轻度粘膜炎期间携带的放线杆菌比例明显较高，这可能在严重粘膜病变的加重中发挥作用。此外，我们的研究结果还表明，基于微生物群的策略可用于早期预测放疗期间严重粘膜炎的发生率。
Oral mucositis is probably the most debilitating complication that can arise in treating a patient with head and neck cancer. Little is known about the impacts of oral microbiota on the initiation and progression of mucositis. Based on 16S rRNA gene sequencing, dynamic changes in oral bacterial profile as well as correlations between the severity of mucositis and bacterial shifts during radiotherapy were investigated. Our results revealed that bacterial community structure altered progressively during radiation therapy, in parallel with a marked increase in the relative abundance of some Gram-negative bacteria. Patients who eventually developed severe mucositis harbored a significantly lower bacterial alpha diversity and higher abundance of Actinobacillus during the phase of erythema – patchy mucositis. Accordingly, a random forest model for predicting exacerbation of mucositis was generated, which achieved a high predictive accuracy (AUC) of 0.89. Oral microbiota changes correlate with the progression and aggravation of radiotherapy-induced mucositis in patients with nasopharyngeal carcinoma. Microbiota-based strategies can be used for the early prediction and prevention of the incidence of severe mucositis during radiotherapy. The oral microbiota of NPC patients are different to that of healthy persons. The biodiversity of oral microbiota changed significantly as mucositis progressed during radiotherapy. Oral microbiota represents a potential strategy for predicting the aggravation of severe mucositis during radiotherapy. Oral or oropharyngeal mucositis is the most common side effect of radiation therapy for head and neck cancers. In this prospective cohort study, we found that changes in an oral microbial community correlated with the progression and aggravation of radiotherapy-induced mucositis in the patients with nasopharyngeal carcinoma; and patients who eventually developed severe mucositis transiently harbored a notably higher proportion of Actinobacillus during a mild phase of mucositis, which may potentially play a role in the aggravation of severe mucosal lesions. Moreover, our findings also showed that microbiota-based strategies can be used for the early prediction of the incidence of severe mucositis during radiotherapy.