Sugimoto Takuya, Yokoyama Yukihiro, Kado Yukiko, Yamamoto Shuta, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Ebata Tomoki, Asahara Takashi
Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Yakult Central Institute, Yakult Honsha Co., Ltd., Kunitachi, Tokyo, Japan.
Ann Surg Oncol. 2025 Sep 12. doi: 10.1245/s10434-025-18298-2.
Gut microbiota and intestinal environment are crucial in minimizing the risk for postoperative infectious complications of major gastrointestinal cancer surgery. However, comprehensive studies across multiple cancer types with large samples are limited. This study aimed to identify preoperative factors associated with the development of infectious complications after such surgeries.
This large-scale exploratory study examined 381 patients who underwent surgery for seven types of gastrointestinal cancer. Preoperative fecal samples were analyzed for fecal organic acid concentrations using high-performance liquid chromatography and gut microbiota composition 16S rRNA gene amplicon-sequencing. The relationships between specific gut bacteria, lactic acid concentrations, and postoperative infectious complications were analyzed.
Fecal lactic acid concentrations were significantly higher in patients who experienced postoperative infectious complications, indicating that lactic acid concentration is an independent risk factor. Greater preoperative abundances of Akkermansia muciniphila and Lactococcus lactis were associated with a lower incidence of postoperative infectious complications. Additionally, A. muciniphila abundance was positively correlated with preoperative blood neutrophil and lymphocyte counts.
Fecal lactic acid concentrations, A. muciniphila, and L. lactis were identified as factors associated with the development or suppression of postoperative infectious complications. These findings suggest novel avenues for predicting and managing infection risks through preoperative assessments and microbiota modulation.
肠道微生物群和肠道环境对于将重大胃肠道癌手术术后感染并发症的风险降至最低至关重要。然而，针对多种癌症类型且样本量较大的综合研究有限。本研究旨在确定此类手术后与感染并发症发生相关的术前因素。
这项大规模探索性研究对381例接受七种胃肠道癌手术的患者进行了检查。术前粪便样本采用高效液相色谱法分析粪便有机酸浓度，并通过16S rRNA基因扩增子测序分析肠道微生物群组成。分析了特定肠道细菌、乳酸浓度与术后感染并发症之间的关系。
发生术后感染并发症的患者粪便乳酸浓度显著更高，表明乳酸浓度是一个独立危险因素。术前嗜黏蛋白阿克曼氏菌和乳酸乳球菌丰度较高与术后感染并发症发生率较低相关。此外，嗜黏蛋白阿克曼氏菌丰度与术前血液中性粒细胞和淋巴细胞计数呈正相关。
粪便乳酸浓度、嗜黏蛋白阿克曼氏菌和乳酸乳球菌被确定为与术后感染并发症发生或抑制相关的因素。这些发现为通过术前评估和微生物群调节来预测和管理感染风险提供了新途径。
