Navarro-Sánchez Adrián, Nieto-Vitoria María Ángeles, López-López José Antonio, Martínez-Crespo Juan José, Navarro-Mateu Fernando
University of Murcia, Murcia, Spain.
Digestive Service, General University Hospital Reina Sofía, Murcia, Spain.
BMC Cancer. 2025 Mar 4;25(1):395. doi: 10.1186/s12885-025-13770-4.
The association between the oral pathogen Porphyromonas gingivalis (PG) and the gut microbiota in colorectal cancer (CRC) patients has been explored with inconsistent results. This study aims to systematically assess this potential association.
A systematic review was conducted across three databases (Pubmed, Embase and Web of Science) from inception up to January 2023 and updated until November 2024. Inclusion criteria were observational studies examining PG in the microbiota of adults with CRC compared to healthy controls. Exclusion criteria were studies without control group of healthy individuals, other designs or without full-text access. Two reviewers independently selected and extracted data following a pre-registered protocol. Disagreements were resolved by consensus or with a third reviewer. Risk of bias (RoB) was assessed using the Newcastle-Ottawa Scale (NOS). Results were summarized with a flow diagram, tables, and narrative descriptions. Meta-analysis was not feasible, so Fisher's method for combining p-values and the sign test were used as alternative integration methods.
Finally, 18 studies, with 23 analysis units were included, providing a total sample of 4,373 participants (48.0% cases and 52.0%controls), 38.2% men and 61.8% women, with a similar distribution among cases and controls. The mean (SD) age of cases was 63.3 (4.382) years old and 57.0 (7.753) years for controls. Most of the studies analyzed the presence of PG in feces (70.0%) collected before colonoscopy (55.0%) and were classified with good quality (70.0%) in the RoB assessment. Results suggested an effect (Fisher's test, p = .000006) with some evidence towards a positive association of PG in CRC patients compared to healthy controls (Sign test, p = .039).
Results of the systematic review suggest that PG is associated with the microbiota of CRC patients. Lack of information to calculate the effect size prevented the performance of a meta-analysis. Future research should aim for standardized protocols and statistical approaches.
No funding was received for this work.
The research protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 2023 (registration number: CRD42023399382).
已对口腔病原体牙龈卟啉单胞菌（PG）与结直肠癌（CRC）患者肠道微生物群之间的关联进行了探索，但结果不一致。本研究旨在系统评估这种潜在关联。
对三个数据库（PubMed、Embase和Web of Science）从建库至2023年1月进行了系统综述，并更新至2024年11月。纳入标准为观察性研究，比较CRC成年患者与健康对照者微生物群中的PG。排除标准为无健康个体对照组的研究、其他设计或无全文获取的研究。两名评审员按照预先注册的方案独立选择和提取数据。分歧通过共识解决或由第三名评审员解决。使用纽卡斯尔-渥太华量表（NOS）评估偏倚风险（RoB）。结果用流程图、表格和叙述性描述进行总结。由于无法进行荟萃分析，因此使用Fisher合并p值法和符号检验作为替代整合方法。
最终纳入18项研究，共23个分析单元，提供了4373名参与者的总样本（48.0%为病例组，52.0%为对照组），其中男性占38.2%，女性占61.8%，病例组和对照组分布相似。病例组的平均（标准差）年龄为63.3（4.382）岁，对照组为57.0（7.753）岁。大多数研究分析了结肠镜检查前（55.0%）采集的粪便（70.0%）中PG的存在情况，并且在RoB评估中被归类为高质量（70.0%）。结果显示存在效应（Fisher检验，p = 0.000006），有一些证据表明CRC患者中PG与健康对照相比呈正相关（符号检验，p = 0.039）。
系统综述结果表明PG与CRC患者的微生物群有关。由于缺乏计算效应量的信息，无法进行荟萃分析。未来的研究应致力于标准化方案和统计方法。
本研究未获得资金支持。
该研究方案于2023年在国际前瞻性系统综述注册库（PROSPERO）注册（注册号：CRD42023399382）。
