Department of Surgery, University of Otago Christchurch, Christchurch, New Zealand.
Biostatistics and Computational Biology Unit, University of Otago Christchurch, Christchurch, New Zealand.
PLoS One. 2022 Jun 3;17(6):e0269541. doi: 10.1371/journal.pone.0269541. eCollection 2022.
Carriage of certain bacterial species may represent potential biomarkers of colorectal cancer (CRC). Prominent among these is Fusobacterium nucleatum. We explored the association of F. nucleatum DNA in stool samples with the presence of colonic neoplastic lesions in a cohort of primary care patients, and compared our findings with those from an unrelated cohort of colonoscopy patients followed clinically over time.
Carriage rates of F. nucleatum in stool samples were assessed in 185 patients referred for a faecal immunochemical test (FIT) by their general practitioners (GPs). Comparisons were made with stool samples from 57 patients diagnosed with CRC and 57 age-matched healthy controls, and with tissue samples taken at colonoscopy from 150 patients with a decade of subsequent clinical follow-up.
F. nucleatum DNA was found at a high rate (47.0%) in stool samples from primary care patients, and more often in stool samples from CRC patients (47.4%) than in healthy controls (7.0%), (P = 7.66E-7). No association was found between carriage of F. nucleatum and FIT positivity (P = 0.588). While evidence of stool-associated F. nucleatum DNA was significantly more likely to indicate a lesion in those primary care patients progressed to colonoscopy (P = 0.023), this finding did not extend to the progression of neoplastic lesions in the 150 patients with a decade of follow up.
The finding of F. nucleatum DNA at similar rates in stool samples from patients diagnosed with CRC and in primary care patients with pre-cancerous lesions supports growing awareness that the presence of these bacteria may be a biomarker for increased risk of disease. However, molecular evidence of F. nucleatum did not predict progression of colonic lesions, which may lessen the utility of this bacterium as a biomarker for increased risk of disease.
某些细菌物种的携带可能代表结直肠癌（CRC）的潜在生物标志物。其中突出的是具核梭杆菌。我们在一组初级保健患者的粪便样本中探索了具核梭杆菌 DNA 的存在与结直肠肿瘤病变的相关性，并将我们的发现与另一组经临床随访多年的结肠镜检查患者的结果进行了比较。
我们评估了 185 名由全科医生（GP）转介进行粪便免疫化学检测（FIT）的患者粪便样本中具核梭杆菌的携带率。并将其与 57 名确诊为 CRC 的患者、57 名年龄匹配的健康对照者的粪便样本进行了比较，并与 150 名经结肠镜检查且随后有 10 年临床随访的患者的组织样本进行了比较。
在初级保健患者的粪便样本中发现具核梭杆菌 DNA 的携带率较高（47.0%），且在 CRC 患者（47.4%）中比在健康对照者（7.0%）中更为常见（P = 7.66E-7）。未发现具核梭杆菌携带与 FIT 阳性之间存在关联（P = 0.588）。虽然粪便中具核梭杆菌 DNA 的存在明显更可能表明那些进展到结肠镜检查的初级保健患者存在病变（P = 0.023），但这一发现并未扩展到 150 名具有 10 年随访的患者的肿瘤病变进展中。
在诊断为 CRC 的患者和有癌前病变的初级保健患者的粪便样本中发现具核梭杆菌 DNA 的携带率相似，这支持了越来越多的认识，即这些细菌的存在可能是疾病风险增加的生物标志物。然而，具核梭杆菌的分子证据并不能预测结直肠病变的进展，这可能降低了该细菌作为疾病风险增加的生物标志物的效用。
