Background

Fusobacterium nucleatum (Fn), a bacterium associated with a wide spectrum of infections, has emerged as a key microbe in colorectal carcinogenesis. However, the underlying mechanisms and clinical relevance of Fn in colorectal cancer (CRC) remain incompletely understood.

Patients and Methods

We examined associations between Fn abundance and clinicopathologic characteristics among 105 treatment-naïve CRC patients enrolled in the international, prospective ColoCare Study. Electronic medical charts, including pathological reports, were reviewed to document clinicopathologic features. Quantitative real-time polymerase chain reaction (PCR) was used to amplify/detect Fn DNA in preoperative fecal samples. Multinomial logistic regression was used to analyze associations between Fn abundance and patient sex, age, tumor stage, grade, site, microsatellite instability, body mass index (BMI), alcohol consumption, and smoking history. Cox proportional hazards models were used to investigate associations of Fn abundance with overall survival in adjusted models.

Results

Compared to patients with undetectable or low Fn abundance, patients with high Fn abundance (n = 22) were 3-fold more likely to be diagnosed with rectal versus colon cancer (odds ratio [OR] = 3.01; 95% confidence interval [CI], 1.06-8.57; P = .04) after adjustment for patient sex, age, BMI, and study site. Patients with high Fn abundance also had a 5-fold increased risk of being diagnosed with rectal cancer versus right-sided colon cancer (OR = 5.32; 95% CI, 1.23-22.98; P = .03). There was no statistically significant association between Fn abundance and overall survival.

Conclusion

Our findings suggest that Fn abundance in fecal samples collected prior to surgery varies by tumor site among treatment-naïve CRC patients. Overall, fecal Fn abundance may have diagnostic and prognostic significance in the clinical management of CRC.

中文翻译：

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具核梭杆菌和结直肠癌的临床病理学特征：ColoCare 研究的结果

背景

具核梭杆菌( Fn ) 是一种与广泛感染相关的细菌，已成为结直肠癌发生的关键微生物。然而， Fn在结直肠癌 (CRC) 中的潜在机制和临床相关性仍未完全了解。

患者和方法

我们检查了参加国际前瞻性 ColoCare 研究的 105 名初治 CRC 患者的Fn丰度与临床病理学特征之间的关联。审查了包括病理报告在内的电子病历，以记录临床病理特征。定量实时聚合酶链反应 (PCR) 用于扩增/检测术前粪便样本中的Fn DNA。多项逻辑回归用于分析Fn丰度与患者性别、年龄、肿瘤分期、分级、部位、微卫星不稳定性、体重指数 (BMI)、饮酒和吸烟史之间的关联。Cox比例风险模型用于研究Fn的关联调整模型中的总体存活率。

结果

与 Fn 丰度无法检测或Fn丰度低的患者相比， Fn丰度高 ( n  = 22) 的患者被诊断为直肠癌和结肠癌的可能性高 3 倍（优势比 [OR] = 3.01；95% 置信区间 [CI] , 1.06-8.57; P = .04) 在对患者性别、年龄、BMI 和研究地点进行调整后。与右侧结肠癌相比，Fn丰度高的患者被诊断为直肠癌的风险也增加了 5 倍（OR = 5.32；95% CI，1.23-22.98； P  = .03）。Fn丰度与总生存率之间没有统计学上的显着关联。

结论

我们的研究结果表明，手术前收集的粪便样本中的Fn丰度因未接受治疗的 CRC 患者的肿瘤部位而异。总体而言，粪便Fn丰度可能在 CRC 的临床管理中具有诊断和预后意义。