Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2019; 11(9): 717-728
Published online Sep 15, 2019. doi: 10.4251/wjgo.v11.i9.717
Correlation between invasive microbiota in margin-surrounding mucosa and anastomotic healing in patients with colorectal cancer
Yan-Dong Li, Kang-Xin He, Wei-Fang Zhu
Yan-Dong Li, Division of Colon and Rectal Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Kang-Xin He, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Wei-Fang Zhu, Division of Dermatology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Li YD, He KX, and Zhu WF contributed equally to this work; He KX and Zhu WF designed the research; Li YD and He KX performed the research; Li YD and He KX analyzed the data; and Li YD, He KX, and Zhu WF wrote the paper.
Supported by Zhejiang Administration of Traditional Chinese Medicine, No. 2017ZA082.
Institutional review board statement: The study protocol was reviewed and approved by the First Affiliated Hospital, Zhejiang University School of Medicine Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Data sharing statement: Data from this manuscript will be available upon request.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wei-Fang Zhu, MD, Assistant Professor, Division of Dermatology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. wfzhu@163.com
Telephone: +86-571-87236559 Fax: +86-571-87236559
Received: July 23, 2019
Peer-review started: July 23, 2019
First decision: August 27, 2019
Revised: August 30, 2019
Accepted: September 4, 2019
Article in press: September 4, 2019
Published online: September 15, 2019
Abstract
BACKGROUND

Impaired anastomotic healing is one of the major complications resulting from radical resection in colorectal cancer (CRC). Accumulating evidence suggests that intestinal microbiota is correlated with anastomotic healing.

AIM

To explore the microbiota structural shift in margin-surrounding mucosa and evaluate the predictive ability of selected bacterial taxa for impaired anastomotic healing.

METHODS

Margin-surrounding mucosa samples derived from 37 patients were collected to characterize the microbial community structure by 16s rRNA gene sequencing. The patients were divided into two groups according to the healing status of anastomoses: well-healing group (n = 30) and impaired-healing group (n = 7). Statistic differences in bacteria taxa were compared by Wilcoxon test and chi-squared test. The predictive ability of the selected bacterial taxa for the healing status of anastomoses was evaluated by the area under the receiver operator characteristic curve.

RESULTS

Community structure shifts were observed in the impaired-healing group and well-healing group. Six bacterial species were found to be significantly correlated with anastomotic healing, and among these species, Alistipes shahii, Dialister pneumosintes, and Corynebacterium suicordis were considered as the predictive factors. Taking the known risk factor age into consideration, Alistipes shahii, Dialister pneumosintes, and Corynebacterium suicordis improved predictive ability for the healing status of anastomoses.

CONCLUSION

These data show that Alistipes shahii, Dialister pneumosintes, and Corynebacterium suicordis could be considered as supplementary factors in the prediction of anastomosis healing status in patients after CRC radical resection.

Keywords: Intestinal microbiota, 16s rRNA gene sequencing, Anastomotic healing, Predictive ability, Colorectal cancer, Radical resection

Core tip: This study investigated the correlation between microbiota in mucosa tissues adjacent to surgical margin and anastomotic healing status. Bacterial community structure significantly varied in the impaired-healing group compared with the well-healing group. The current study was the first to demonstrate that six bacterial species were associated with the anastomotic healing in colorectal cancer (CRC) patients. Notably, Alistipes shahii, Dialister pneumosintes, and Corynebacterium suicordis in combination with age improved the accuracy for predicting the healing status of anastomoses. Thus, the three species could be used as the supplementary factors in predicting the healing status of anastomoses in CRC patients after radical resection of CRC.