Department of General Surgery, Renmin Hospital of Wuhan University, No.238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
Hubei Key Laboratory of Digestive System Disease, No.238, Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
J Transl Med. 2023 Feb 15;21(1):126. doi: 10.1186/s12967-023-03940-y.
OBJECTIVE: Gut mycobiota plays a crucial role in benign liver diseases; however, its correlation with hepatocellular carcinoma (HCC) remains elusive. This study aimed to elucidate fungal differences in patients with HCC-associated cirrhosis compared to cirrhotic patients without HCC and healthy controls. METHODS: The 72 fecal samples from 34 HCC patients, 20 cirrhotic patients, and 18 healthy controls were collected and analyzed using ITS2 rDNA sequencing. RESULTS: Our results revealed the presence of intestinal fungal dysbiosis with significant enrichment of opportunistic pathogenic fungi such as Malassezia, Malassezia sp., Candida, and C. albicans in HCC patients compared with healthy controls and cirrhosis patients. Alpha-diversity analysis demonstrated that patients with HCC and cirrhosis showed decreased fungal diversity compared to healthy controls. Beta diversity analysis indicated that the three groups exhibited significant segregated clustering. Besides, C. albicans was found to be significantly more abundant in the HCC patients with TNM stage III-IV than those with stage I-II, in contrast to the commensal organism S. cerevisiae. We also confirmed that the HCC patients were successfully classified with an area under the curve value of 0.906 based on the fecal fungal signature. Finally, our animal experiments confirm that aberrant colonization of the intestine by C. albicans and M. furfur can promote the development of HCC. CONCLUSIONS: This study indicates that dysbiosis of the gut mycobiome might be involved in HCC development. TRIAL REGISTRATION: ChiCTR, ChiCTR2100054537. Registered 19 December 2021, http://www.chictr.org.cn/edit.aspx?pid=144550&htm=4.
目的:肠道微生物群在良性肝病中起着至关重要的作用;然而,其与肝细胞癌(HCC)的相关性仍不清楚。本研究旨在阐明与 HCC 相关的肝硬化患者与无 HCC 的肝硬化患者和健康对照者之间真菌的差异。
方法:收集了 34 名 HCC 患者、20 名肝硬化患者和 18 名健康对照者的 72 份粪便样本,并使用 ITS2 rDNA 测序进行分析。
结果:我们的结果显示,与健康对照组和肝硬化组相比,HCC 患者存在肠道真菌失调,机会性致病真菌如马拉色菌、马拉色菌属、假丝酵母属和白色假丝酵母属明显富集。α多样性分析表明,HCC 患者和肝硬化患者的真菌多样性较健康对照组降低。β多样性分析表明,三组之间存在显著的聚类分离。此外,与共生菌酿酒酵母相反,我们发现 C. albicans 在 TNM 分期为 III-IV 期的 HCC 患者中明显更丰富。我们还证实,基于粪便真菌特征,HCC 患者可以被成功分类,曲线下面积值为 0.906。最后,我们的动物实验证实,C. albicans 和 M. furfur 肠道的异常定植可以促进 HCC 的发展。
结论:本研究表明,肠道微生物群的失调可能参与了 HCC 的发生。
试验注册:ChiCTR,ChiCTR2100054537。于 2021 年 12 月 19 日注册,http://www.chictr.org.cn/edit.aspx?pid=144550&htm=4。
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