Chen Yanglong, Lu Ying, Ke Yuting, Li Yanling
Department of Emergency Surgery.
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2019 Sep;98(39):e17221. doi: 10.1097/MD.0000000000017221.
To investigate the clinicopathological features and prognostic impact of Fusobacterium nucleatum (F nucleatum) status in patients with colorectal cancer (CRC) and its relationships with microsatellite instability (MSI) status.Retrospective analysis of consecutive 91 CRC tissues from surgically resected specimens of stage III or high-risk stage II CRC patients who had received curative surgery in Wuhan Union Hospital from January, 2017 to January, 2019 was conducted. F nucleatum DNA was quantitatively measured and classified into 1 of the 2 categories: F nucleatum-high, or F nucleatum-low/negative. The Cox risk ratio model analysis was performed to identify independent risk factors of F nucleatum. F nucleatum-high group was compared with the F nucleatum-low/negative group with respect to clinicopathological features and their relationships with MSI status. Kaplan-Meier method and log-rank test were used for univariate analysis of prognostic factors in patients with CRC.The number of total lymph node acquisition and positive lymph nodes, neurological invasion, vascular tumor thrombus were higher in F nucleatum-high group (27.44 ± 25.213 vs 20.70 ± 10.141; P = .018; 3.80 ± 7.974 vs 1.74 ± 3.531; P = .001; 68.0% vs 33.3%; P = .003; 60.0% vs 25.8%; P = .002). Moreover, microsatellite mutations were more frequent in patients with F nucleatum-high (84.0% vs 60.6%; P = .034). A higher abundance of F nucleatum in CRC is associated with a shorter survival time. The F nucleatum status, peripheral nerve invasion, vascular tumor thrombus, lymph node metastasis, and TNM staging were related factors affecting the prognosis of patients with CRC. The Cox risk ratio model analysis showed that the F nucleatum (odds ratio [OR] 2.094, 95% confidence interval [CI] 1.178-8.122, P = .032) and MSI status (OR 2.243, 95% CI 1.136-5.865, P = 0.039) were independent prognostic factors.Intratumoral F nucleatum load has a poor prognostic effect of CRC by increasing nerve invasion, vascular tumor thrombus, and microsatellite mutation.
探讨具核梭杆菌(F核梭杆菌)状态在结直肠癌(CRC)患者中的临床病理特征、预后影响及其与微卫星不稳定性(MSI)状态的关系。对2017年1月至2019年1月在武汉协和医院接受根治性手术的III期或高危II期CRC患者手术切除标本中的91例连续CRC组织进行回顾性分析。定量检测F核梭杆菌DNA并将其分为两类中的一类:F核梭杆菌高或F核梭杆菌低/阴性。进行Cox风险比模型分析以确定F核梭杆菌的独立危险因素。比较F核梭杆菌高组与F核梭杆菌低/阴性组的临床病理特征及其与MSI状态的关系。采用Kaplan-Meier法和对数秩检验对CRC患者的预后因素进行单因素分析。F核梭杆菌高组的总淋巴结获取数和阳性淋巴结数、神经侵犯、血管肿瘤血栓更高(27.44±25.213对20.70±10.141;P = 0.018;3.80±7.974对1.74±3.531;P = 0.001;68.0%对33.3%;P = 0.003;60.0%对25.8%;P = 0.002)。此外,F核梭杆菌高的患者微卫星突变更频繁(84.0%对60.6%;P = 0.034)。CRC中F核梭杆菌丰度较高与生存时间较短相关。F核梭杆菌状态、周围神经侵犯血管肿瘤血栓、淋巴结转移和TNM分期是影响CRC患者预后的相关因素。Cox风险比模型分析显示,F核梭杆菌(比值比[OR]2.094,95%置信区间[CI]1.178 - 8.122,P = 0.032)和MSI状态(OR 2.243,95%CI 1.136 - 5.865,P = 0.039)是独立的预后因素。肿瘤内F核梭杆菌负荷通过增加神经侵犯、血管肿瘤血栓和微卫星突变对CRC具有不良预后作用。