The Affiliated Hospital, Southwest Medical University, Luzhou 611630, China; Department of General Medicine, General Hospital of PLA Western Theater Command, Chengdu 610083, China.
Department of Nursing, Nursing School, Chengdu Medical College, Chengdu 610083, China.
Microb Pathog. 2024 Aug;193:106784. doi: 10.1016/j.micpath.2024.106784. Epub 2024 Jul 4.
Esophageal cancer (EC) possesses a high degree of malignancy and exhibits poor therapeutic outcomes and prognosis. However, its pathogenesis remains unclear. With the development of macrogene sequencing technology, changes in the intestinal flora have been found to be highly related to the development of EC, although discrepancies and controversies remain in this research area.
We comprehensively searched the PubMed, EMBASE, and Cochrane's Central Controlled Trials Register and the Scientific Network's database search projects based on systematically reviewed preferred reporting projects and meta-analyses. We used Engauge Digitizer for data extraction and Stata 15.1 for data analysis. In addition, we used the Newcastle-Ottawa Scale for grade grading and forest and funnel plots, sensitivity, and Egger and Beggar tests to evaluate the risk of bias.
This study included 10 studies that assessed stool, tumor, and nontumor esophageal mucosa (gastroscopy and surgical resection) samples from 527 individuals, including 273 patients with EC and 254 healthy control group. We observed remarkable differences in microbial diversity in EC patients compared to healthy controls. The Chao1 index (46.01 vs. 42.67) was significantly increased in EC patients, whereas the Shannon index (14.90 vs. 19.05), ACE (39.24 vs. 58.47), and OTUs(28.93 vs. 70.10) were significantly lower. At the phylum level, the abundance of Bacteroidetes (37.89 vs. 32.77) increased significantly, whereas that of Firmicutes (37.63 vs. 38.72) decreased significantly; the abundance of Clostridium and Verruciformis increased, while that of Actinobacteria and Proteobacteria decreased to varying degrees. The abundance of Bacteroides (8.60 vs. 15.10) and Streptococcaceae (15.08 vs. 27.05) significantly reduced in EC.
According to our meta-analysis, in patients with EC, the Chao1 index increased, whereas the Shannon and the OTUs decreased. At the phylum level, the abundance of Firmicutes decreased significantly, whereas that of Bacteroidetes and Proteobacteria increased significantly. At the genus/family level, the abundance of Bacteroidaceae, Prevotellaceae and Streptococcaceae decreased significantly, whereas that of Veillonellaceae increased. This meta-analysis identified changes in gut microbiota in patients with EC; however, its conclusions were inconsistent.
食管癌（EC）恶性程度高，治疗效果和预后差。但其发病机制尚不清楚。随着宏基因组测序技术的发展，肠道菌群的变化与 EC 的发生发展密切相关，但该研究领域仍存在差异和争议。
我们全面检索了 PubMed、EMBASE 和 Cochrane 中央对照试验登记处以及科学网络数据库搜索项目，基于系统综述的首选报告项目和荟萃分析进行检索。我们使用 Engauge Digitizer 进行数据提取，使用 Stata 15.1 进行数据分析。此外，我们使用纽卡斯尔-渥太华量表进行分级评分，使用森林图和漏斗图、敏感性、Egger 和 Beggar 检验评估偏倚风险。
本研究纳入了 10 项研究，评估了 527 名个体的粪便、肿瘤和非肿瘤食管黏膜（胃镜和手术切除）样本，包括 273 名 EC 患者和 254 名健康对照组。我们观察到 EC 患者的微生物多样性与健康对照组有显著差异。Chao1 指数（46.01 比 42.67）在 EC 患者中显著增加，而 Shannon 指数（14.90 比 19.05）、ACE（39.24 比 58.47）和 OTUs（28.93 比 70.10）显著降低。在门水平上，厚壁菌门（37.89 比 32.77）的丰度显著增加，而拟杆菌门（37.63 比 38.72）的丰度显著降低；梭菌属和疣微菌属的丰度增加，而放线菌门和变形菌门的丰度则不同程度地降低。Bacteroides（8.60 比 15.10）和 Streptococcaceae（15.08 比 27.05）在 EC 中的丰度显著降低。
根据我们的荟萃分析，在 EC 患者中，Chao1 指数增加，而 Shannon 和 OTUs 减少。在门水平上，厚壁菌门的丰度显著降低，而拟杆菌门和变形菌门的丰度显著增加。在属/科水平上，拟杆菌科、普雷沃氏菌科和链球菌科的丰度显著降低，而韦荣球菌科的丰度增加。本荟萃分析确定了 EC 患者肠道微生物群的变化，但结论不一致。
