Department of Gynaecology and Obstetrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Gynaecology and Obstetrics, Hefei Hospital Affiliated to Anhui Medical University, Anhui, China.
Medicine (Baltimore). 2024 Sep 13;103(37):e39596. doi: 10.1097/MD.0000000000039596.
Endometrial cancer (EC) is the most prevalent gynecologic malignancy, with a higher risk in obese women, suggesting the potential involvement of gut microbiota in the progression of EC. However, there is no direct evidence of a connection between EC and the human gut microbiota. Using metagenomic sequencing, we investigated the relationship between gut microbiome imbalance and cancer development in patients with EC. In this prospective case-control study, we included 15 patients with EC based on endometrial biopsy in the case group and 15 women admitted to the hospital for female pelvic floor issues during the same time who did not have endometrial lesions from January 2023 to June 2023 in control group. The microbiota structure of EC cases and controls without benign or malignant endometrial lesions during the same time period was analyzed using metagenomic sequencing technology. We employed Alpha diversity analysis to reflect the richness and diversity of microbial communities. Statistical algorithm Bray-Curtis was utilized to calculate pairwise distances between samples, obtaining a beta diversity distance matrix. Subsequently, hierarchical clustering analysis was conducted based on the distance matrix. The results showed that the composition of bacterial colonies in both groups was dominated by Firmicutes, which had a higher proportion in the control group, followed by Bacteroidetes in the control group and Proteobacteria and Bacteroidetes in the case group. The abundance of Klebsiella (P = .02) was significantly higher, and the abundance of Alistipes (P = .04), Anearobutyricum (P = .01), and bacteria in Firmicutes such as Oscillospira and Catenibacterium was markedly lower in the case group than in the control group. These results demonstrated conclusively that a gut microbiome imbalance was associated with the development of EC.
子宫内膜癌（EC）是最常见的妇科恶性肿瘤，肥胖女性的风险更高，这表明肠道微生物群在 EC 的发展中可能有一定作用。然而，目前还没有直接证据表明 EC 与人类肠道微生物群之间存在联系。我们使用宏基因组测序研究了肠道微生物群失衡与 EC 患者癌症发展之间的关系。在这项前瞻性病例对照研究中，我们纳入了 15 名基于子宫内膜活检的 EC 患者（病例组），并纳入了 15 名 2023 年 1 月至 6 月因女性盆底问题入院且无子宫内膜病变的女性（对照组）。我们使用宏基因组测序技术分析了 EC 病例和同期无良性或恶性子宫内膜病变的对照组的微生物群结构。我们采用 Alpha 多样性分析来反映微生物群落的丰富度和多样性。使用统计算法 Bray-Curtis 计算样本之间的成对距离，获得 beta 多样性距离矩阵。然后，根据距离矩阵进行层次聚类分析。结果表明，两组细菌菌落的组成均以厚壁菌门为主，对照组的比例较高，其次是拟杆菌门，对照组和病例组的变形菌门和拟杆菌门比例较高。克雷伯菌属（P =.02）的丰度明显较高，而病例组拟杆菌属（P =.04）、厌氧棒状菌属（P =.01）和厚壁菌门中的 Oscillospira 和 Catenibacterium 等细菌的丰度明显低于对照组。这些结果明确表明，肠道微生物群失衡与 EC 的发展有关。
