Zeng Jiarong, Zhang Guihao, Chen Chunxiao, Li Kun, Wen Yuehui, Zhao Jie, Wu Peng
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Urology, Meizhou People's Hospital (Huangtang Hospital), Meizhou, China.
Front Cell Infect Microbiol. 2020 Dec 15;10:555508. doi: 10.3389/fcimb.2020.555508. eCollection 2020.
Numerous studies indicate that resident microbiome exists in urine of healthy individuals and dysbiosis of the urobiome (urinary microbiome) may be associated with pathological conditions. This study was performed to characterize the alterations in urobiome and explore its implications of clinical outcome in male patients with bladder cancer. 62 male patients with bladder cancer and 19 non-neoplastic controls were recruited. The follow-up study cohort included 40 patients who were diagnosed with non-muscle invasive bladder cancer (NMIBC) and underwent transurethral resection of bladder tumor (TURBT). Mid-stream urine samples were collected from all the participants the day before cystoscopy. DNA was extracted from urine pellet samples and processed for high throughput 16S rRNA amplicon sequencing of the V4 region using Illumina MiSeq. Sequencing reads were filtered using QIIME and clustered using UPARSE. We found bacterial richness indices (Observed Species index, Chao1 index, Ace index; all < 0.01) increased in cancer group when compared with non-neoplastic group, while there were no differences in Shannon and Simpson index between two groups. During a median follow-up time of 12 (5.25-25) months, 5/40 (12.5%)of the patients developed recurrence and no patient suffered from progression to muscle-invasive disease. Species diversity of the microbiome was significantly higher in the recurrence group compared with non-recurrence group in patients with NMIBC after TURBT. The LEfSe analysis demonstrated that 9 genera were increased (e.g., and ) in recurrence group. To our knowledge we report the relative comprehensive study to date of the male bladder cancer urinary microbiome and its relationship to pathogenesis and clinical outcomes. Given our preliminary data, additional studies evaluating the urine microbiome in relation to clinical outcomes are warranted to improve our understanding of tumor recurrence after TURBT.
大量研究表明，健康个体的尿液中存在常驻微生物群，而泌尿微生物群（尿液微生物群）的失调可能与病理状况有关。本研究旨在描述泌尿微生物群的变化，并探讨其对男性膀胱癌患者临床结局的影响。招募了62例男性膀胱癌患者和19例非肿瘤对照。随访研究队列包括40例被诊断为非肌层浸润性膀胱癌（NMIBC）并接受经尿道膀胱肿瘤切除术（TURBT）的患者。在膀胱镜检查前一天从所有参与者中收集中段尿样本。从尿沉渣样本中提取DNA，并使用Illumina MiSeq对V4区域进行高通量16S rRNA扩增子测序。使用QIIME过滤测序读数，并使用UPARSE进行聚类。我们发现，与非肿瘤组相比，癌症组的细菌丰富度指数（观察物种指数、Chao1指数、Ace指数；均<0.01）增加，而两组之间的香农指数和辛普森指数没有差异。在中位随访时间12（5.25-25）个月期间，5/40（12.5%）的患者出现复发，没有患者进展为肌层浸润性疾病。TURBT术后NMIBC患者中，复发组微生物群的物种多样性明显高于未复发组。LEfSe分析表明，复发组中有9个属增加（如 和 ）。据我们所知，我们报告了迄今为止关于男性膀胱癌尿液微生物群及其与发病机制和临床结局关系的相对全面的研究。鉴于我们的初步数据，有必要进行更多评估尿液微生物群与临床结局关系的研究，以增进我们对TURBT后肿瘤复发的理解。
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