Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Dysbiosis of the duodenal microbiota as a diagnostic marker for pancreaticobiliary cancer
Mitsuru Sugimoto, Kazumichi Abe, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Ryoichiro Kobashi, Takuto Hikichi, Hiromasa Ohira
Mitsuru Sugimoto, Kazumichi Abe, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Ryoichiro Kobashi, Hiromasa Ohira, Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Minami Hashimoto, Tsunetaka Kato, Ryoichiro Kobashi, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1295, Japan
Author contributions: Sugimoto M wrote the paper and designed and performed the research and laboratory experiments; Abe K provided advice on the laboratory experiments and research; Takagi T, Suzuki R, Konno N, Asama H, Sato Y, Irie H, Watanabe K, Nakamura J, Kikuchi H, Takasumi M, Hashimoto M, Kato T, and Kobashi R provided clinical advice; Hikichi T supervised the report; Ohira H supervised the report and writing of the paper.
Institutional review board statement: This study was approved by the Institutional Review Board of Fukushima Medical University (Approval No. 2451).
Conflict-of-interest statement: The authors declare no competing interests.
Data sharing statement: The datasets analyzed during the current study are available from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: Mitsuru Sugimoto, MD, PhD, Assistant Professor, Doctor, Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan. kitachuuou335@yahoo.co.jp
Received: March 22, 2021
Peer-review started: March 22, 2021
First decision: July 3, 2021
Revised: July 10, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: December 15, 2021
ARTICLE HIGHLIGHTS
Research background
Pancreaticobiliary cancer (PB Ca) is a lethal disease; however, there are currently no appropriate diagnostic and prognostic markers. Recently, the human microbiota was reported to be a causative factor, diagnostic marker, and prognostic marker for gastrointestinal malignant diseases.
Research motivation
The oral and fecal microbiota have been reported to be useful diagnostic markers for gastrointestinal cancer. The duodenum is located closer to the pancreas and bile duct than the oral cavity and colon. Therefore, we hypothesized that assessment of the duodenal microbiota might improve the diagnostic accuracy for PB Ca.
Research objectives
To investigate the diagnostic accuracy of duodenal microbiota evaluation for PB Ca.
Research methods
Thirty-four PB Ca and benign pancreaticobiliary disease patients were recruited for this study, and their duodenal juice was aseptically collected by endoscopy. The duodenal microbiota was analyzed, and the relative abundances of species in the duodenal microbiota were compared between PB Ca patients and benign pancreaticobiliary disease patients. The PB Ca diagnosability was compared between a conventional tumor marker and species in the duodenal microbiota with significantly different abundances in PB Ca patients vs benign pancreaticobiliary disease patients.
Research results
The abundances of cancer antigen 19-9 (CA19-9), Bifidobacterium, Clostridium cluster XVIII, and Prevotella were significantly different between PB Ca patients and benign pancreaticobiliary disease patients. The diagnostic capacity of Clostridium cluster XVIII was the highest among the four markers (CA19-9, Bifidobacterium, Clostridium cluster XVIII, and Prevotella). The combined assessment of Clostridium cluster XVIII and CA19-9 Levels was useful for PB Ca diagnosis.
Research conclusions
It was possible to investigate the microbiota of duodenal juice. Duodenal microbiota evaluation may contribute to the diagnosis of PB Ca.
Research perspectives
In the future, novel diagnostic and prognostic markers and treatments could be developed by investigating the relationship between the duodenal microbiota and PB Ca.
