肿瘤内微生物群影响无肺部感染的非小细胞肺癌患者的一线治疗效果和生存。
Intratumoral Microbiota Impacts the First-Line Treatment Efficacy and Survival in Non-Small Cell Lung Cancer Patients Free of Lung Infection.
机构信息
Department of Oncology, Graduate School, Hebei Medical University, Shijiazhuang 050017, China.
Department of Oncology, Shijiazhuang People's Hospital, Shijiazhuang 050030, China.
出版信息
J Healthc Eng. 2022 Feb 7;2022:5466853. doi: 10.1155/2022/5466853. eCollection 2022.
BACKGROUND
It has been known that there are microecology disorders during lung cancer development. Theoretically, intratumoral microbiota (ITM) can impact the lung cancer (LC) survival and treatment efficacy. This study conducted a follow-up investigation of non-small cell lung cancer (NSCLC) patients without lung infection to prove whether ITM indeed impacts the first-line treatment efficacy and survival.
METHODS
We enrolled all patients diagnosed with NSCLC in our department from 2017 to 2019, whose tumor samples were available (through surgery or biopsy) and sent for pathogen-targeted sequencing. All patients received the first-line treatment according to the individual situation. In the short term, the efficacy of the first-line treatment was recorded. During the follow-up, the survival status, progress events, and overall survival (OS) period were recorded if a patient was contacted.
RESULTS
Firstly, 53 patients were included, and our following analysis focused on the stage III and stage IV cases with ADC, SCC, or ASC tumors (47 cases). Several bacteria are associated with the LC status and progression, including N stages, metastasis sites, epidermal growth factor receptor (EGFR) mutation, first-line outcome, and later survival. The risk bacteria include , , , and ; and the protective (against LC development and progression) ones include and . In the logistic regression, the two-year survival can be predicted using the results of four bacteria (, , , and ), with an accuracy rate of 90.7%.
CONCLUSION
ITM have links to malignancy, EGFR mutation, first-line outcome, and survival of NSCLC. Our results implied the potential anti-NSCLC activity of antibiotics when used reasonably. It is still necessary to deepen the understanding of the characteristics of ITM and its interactions with NSCLC tumors and the immune cells, which is significant in individualized approaches to the LC treatment.
背景
众所周知，在肺癌发生过程中存在微生态失调。理论上，肿瘤内微生物群（ITM）可以影响肺癌（LC）的生存和治疗效果。本研究对无肺部感染的非小细胞肺癌（NSCLC）患者进行了随访调查，以证明 ITM 是否确实影响一线治疗效果和生存。
方法
我们招募了 2017 年至 2019 年在我科诊断为 NSCLC 的所有患者，这些患者的肿瘤样本可用（通过手术或活检获得）并进行了病原体靶向测序。所有患者根据个人情况接受一线治疗。在短期内，记录一线治疗的疗效。在随访过程中，如果患者可以联系到，则记录其生存状况、进展事件和总生存（OS）期。
结果
首先，纳入了 53 例患者，我们的后续分析重点是 III 期和 IV 期具有 ADC、SCC 或 ASC 肿瘤的患者（47 例）。一些细菌与 LC 状态和进展有关，包括 N 分期、转移部位、表皮生长因子受体（EGFR）突变、一线结果和后续生存。风险细菌包括 、 、 和 ；保护（防止 LC 发生和进展）的细菌包括 和 。在逻辑回归中，使用 4 种细菌（ 、 、 和 ）的结果可以预测两年生存率，准确率为 90.7%。
结论
ITM 与恶性肿瘤、EGFR 突变、一线结果和 NSCLC 患者的生存有关。我们的结果暗示了合理使用抗生素对 NSCLC 具有潜在的治疗活性。深入了解 ITM 的特征及其与 NSCLC 肿瘤和免疫细胞的相互作用仍然是必要的，这对 LC 治疗的个体化方法具有重要意义。
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