脆弱拟杆菌作为结直肠癌潜在预后因素的临床意义。
Clinical significance of Bacteroides fragilis as a potential prognostic factor in colorectal cancer.
机构信息
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan; University of Chile and TMDU Joint Degree Doctoral Program in Medical Sciences with Mention of a Medical Specialty, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
Department of Specialized Surgeries, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima Bunkyo-ku, Tokyo, Japan; Department of Clinical Oncology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
出版信息
Anaerobe. 2023 Dec;84:102784. doi: 10.1016/j.anaerobe.2023.102784. Epub 2023 Oct 6.
INTRODUCTION
Bacteroides fragilis (B. fragilis) is considered to act in an anti-inflammatory manner on the intestinal tract. On the contrary, enterotoxigenic B. fragilis (ETBF), a subtype of B. fragilis, produces an enterotoxin (BFT; B. fragilis toxin), leading to asymptomatic chronic infections and colonic tumor formation. However, the impact of B. fragilis and ETBF on the clinical outcome of colorectal cancer (CRC) remains unclear. We aim to assess whether their presence affects the outcome in patients with CRC after curative resection.
METHODS
We obtained 197 pairs of matched formalin-fixed paraffin-embedded samples from cancerous and adjacent non-cancerous tissues of patients with pathological stage (pstage) II and III CRC after curative resection. The presence of B. fragilis and ETBF were estimated using real-time polymerase chain reaction, and recurrence-free survival (RFS) and overall survival (OS) of the patients were analyzed.
RESULTS
16S rRNA for B. fragilis and bft DNA were detected in 120 (60.9%) and 12 (6.1%) of the 197 patients, respectively. B. fragilis-positive patients had better RFS than B. fragilis-negative patients, although that was not statistically significant. In subgroup analysis, better outcomes on RFS were observed in the presence of B. fragilis in pstage II and left-sided CRC. The association of B. fragilis positivity on OS was accentuated in the depth of T4 subgroup. No significant differences were observed in RFS and OS between ETBF and non-toxigenic B. fragilis.
CONCLUSIONS
Our findings suggest that the presence of B. fragilis is associated with better outcomes in patients with pstage II and III CRC after curative resection.
简介
脆弱拟杆菌（B. fragilis）被认为对肠道具有抗炎作用。相反，肠毒素脆弱拟杆菌（ETBF）是脆弱拟杆菌的一种亚型，会产生肠毒素（BFT；脆弱拟杆菌毒素），导致无症状慢性感染和结肠肿瘤形成。然而，脆弱拟杆菌和 ETBF 对结直肠癌（CRC）患者临床结局的影响尚不清楚。我们旨在评估它们的存在是否会影响接受根治性切除术后 CRC 患者的结局。
方法
我们从接受根治性切除术后病理分期（pstage）为 II 期和 III 期 CRC 的患者的癌组织和癌旁非癌组织中获得了 197 对配对的福尔马林固定石蜡包埋样本。使用实时聚合酶链反应来估计脆弱拟杆菌和 ETBF 的存在情况，并分析患者的无复发生存率（RFS）和总生存率（OS）。
结果
在 197 例患者中，分别有 120 例（60.9%）和 12 例（6.1%）检测到 16S rRNA 脆弱拟杆菌和 bft DNA。脆弱拟杆菌阳性患者的 RFS 优于脆弱拟杆菌阴性患者，但差异无统计学意义。亚组分析显示，在 pstage II 和左半结直肠癌中，存在脆弱拟杆菌与 RFS 更好相关。在 T4 亚组中，脆弱拟杆菌阳性与 OS 的关联更加明显。ETBF 和非致病毒株脆弱拟杆菌在 RFS 和 OS 方面无显著差异。
结论
我们的研究结果表明，在接受根治性切除术后的 pstage II 和 III 期 CRC 患者中，脆弱拟杆菌的存在与更好的结局相关。
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