Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2020; 26(48): 7679-7692
Published online Dec 28, 2020. doi: 10.3748/wjg.v26.i48.7679
Oral microbiome and pancreatic cancer
Ai-Lin Wei, Mao Li, Guo-Qing Li, Xuan Wang, Wei-Ming Hu, Zhen-Lu Li, Jue Yuan, Hong-Ying Liu, Li-Li Zhou, Ka Li, Ang Li, Mei Rosemary Fu
Ai-Lin Wei, Mao Li, Wei-Ming Hu, Zhen-Lu Li, Jue Yuan, Hong-Ying Liu, Li-Li Zhou, Ang Li, Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Ai-Lin Wei, Key Laboratory of Transplant Engineering and Immunology, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Guo-Qing Li, Xuan Wang, West China School of Public Health/West China fourth Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Ka Li, West China Hospital/West China School of Nursing, Sichuan University, Chengdu 610000, Sichuan Province, China
Mei Rosemary Fu, Boston College William F. Connell School of Nursing, Boston College William F. Connell School, MA, 02467, United States
Author contributions: Li A and Fu MR contributed equally to this work; Fu MR, Li A, Wei AL, Hu WM, and Li K designed the study; Wei AL, Fu MR, and Zhou LL were responsible for the methodology and development stages of the manuscript; Wang X and Li GQ collected samples; Li M, Yuan J, Li ZL, Liu HY, and Wei AL obtained and analyzed the clinical data; Wei AL and Fu MR wrote a draft; All authors wrote the manuscript.
Supported by Expert Funding of National Natural Science Foundation of China, No. 81773174; 1·3·5 project for disciplines of excellence- Clinical Research Incubation and Innovation Project, West China Hospital, Sichuan University, No. ZYJC18044; Clinical Research Incubation and Innovation Project of West China Hospital, No. 2019HXFH009; Science and technology project of Sichuan Province, No. 2020YFS0264.
Institutional review board statement: The Institutional Review Board of the West China Hospital, Sichuan University approved this prospective study.
Informed consent statement: All participants signed written informed consent.
Conflict-of-interest statement: No potential conflicts of interest were disclosed.
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: Ang Li, MD, Professor, Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610000, Sichuan Province, China. angli@scu.edu.cn
Received: October 16, 2020
Peer-review started: October 16, 2020
First decision: November 3, 2020
Revised: November 15, 2020
Accepted: December 6, 2020
Article in press: December 6, 2020
Published online: December 28, 2020
Processing time: 70 Days and 1.9 Hours
Abstract
BACKGROUND

Microbiota profiles differ between patients with pancreatic cancer and healthy people, and understanding these differences may help in early detection of pancreatic cancer. Saliva sampling is an easy and cost-effective way to determine microbiota profiles compared to fecal and tissue sample collection.

AIM

To investigate the saliva microbiome distribution in patients with pancreatic adenocarcinoma (PDAC) and the role of oral microbiota profiles in detection and risk prediction of pancreatic cancer.

METHODS

We conducted a prospective study of patients with pancreatic cancer (n = 41) and healthy individuals (n = 69). Bacterial taxa were identified by 16S ribosomal ribonucleic acid gene sequencing, and a linear discriminant analysis effect size algorithm was used to identify differences in taxa. Operational taxonomic unit values of all selected taxa were converted into a normalized Z-score, and logistic regressions were used to calculate risk prediction of pancreatic cancer.

RESULTS

Compared with the healthy control group, carriage of Streptococcus and Leptotrichina (z-score) was associated with a higher risk of PDAC [odds ratio (OR) = 5.344, 95% confidence interval (CI): 1.282-22.282, P = 0.021 and OR = 6.886, 95%CI: 1.423-33.337, P = 0.016, respectively]. Veillonella and Neisseria (z-score) were considered a protective microbe that decreased the risk of PDAC (OR = 0.187, 95%CI: 0.055-0.631, P = 0.007 and OR = 0.309, 95%CI: 0.100-0.952, P = 0.041, respectively). Among the patients with PDAC, patients reporting bloating have a higher abundance of Porphyromonas (P = 0.039), Fusobacterium (P = 0.024), and Alloprevotella (P = 0.041); while patients reporting jaundice had a higher amount of Prevotella (P = 0.008); patients reporting dark brown urine had a higher amount of Veillonella (P = 0.035). Patients reporting diarrhea had a lower amount of Neisseria and Campylobacter (P = 0.024 and P = 0.034), and patients reporting vomiting had decreased Alloprevotella (P = 0.036).

CONCLUSION

Saliva microbiome was able to distinguish patients with pancreatic cancer and healthy individuals. Leptotrichia may be specific for patients living in Sichuan Province, southwest China. Symptomatic patients had different bacteria profiles than asymptomatic patients. Combined symptom and microbiome evaluation may help in the early detection of pancreatic cancer.

Keywords: Oral microbiota; Dysbiosis; Pancreatic cancer; Cancer detection; 16s rRNA; High-throughput sequencing

Core Tip: Pancreatic adenocarcinoma (PDAC) patients benefit from early detection. This study analyzed the composition and diversity of saliva microbiota in PDAC patients through 16S ribosomal ribonucleic acid sequencing. Normalized z-score of bacteria abundance associated clinical data were analyzed for PDAC risk prediction. Microbiome abundance differences were found between PDAC patients with symptoms and patients without symptoms. Combined symptom and microbiome evaluation may help in early detection and risk prediction of pancreatic cancer.