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
Processing time: 51 Days and 2.1 Hours
ARTICLE HIGHLIGHTS
Research background

The clinical symptoms of impaired anastomotic healing are typically not recognized. However, if not appropriately treated in time, impaired healing could easily evolve into severe postoperative complications. Thus, early diagnosis and prediction of impaired anastomotic healing are highly necessary.

Research motivation

A large number of studies reported that intestinal microbiota contributes to the development of impaired anastomotic healing. A full understanding of the role of intestinal microbiota in anastomotic healing can help identify high-risk patients and alleviate the potentially serious clinical outcomes caused by impaired anastomotic healing.

Research objectives

To identify the specific bacteria related to impaired anastomotic healing and to evaluate the predictive ability of the microbiota taxa for the healing status of anastomoses.

Research methods

Margin-surrounding mucosa samples derived from seven colorectal cancer (CRC) patients with impaired anastomotic healing and thirty well-healed CRC patients were respectively collected and the bacterial community was characterized by 16s rRNA gene sequencing. Wilcoxon test and chi-squared test were performed to analyze the statistic differences of bacterial taxa in the two groups. The predictive ability of the bacterial taxa for the healing status of anastomoses was evaluated by the area under the receiver operator characteristic curve.

Research results

The community structure was different between the impaired-healing and the well-healing groups. Six bacteria species (Alistipes shahii, Dialister pneumosintes, Corynebacterium suicordis, Porphyromonas asaccharolytica, Vibrio diazotrophicus, and Clostridium leptum) were significantly correlated with anastomotic healing. Age was highly associated with the impaired healing of anastomoses. Three bacteria species (Alistipes shahii, Dialister pneumosintes, and Corynebacterium suicordis) in combination with age noticeably improved the accuracy for predicting the healing status of anastomoses.

Research conclusions

The mucosa-invasive microbiota was associated with the anastomotic healing in the research subjects. Alistipes shahii, Dialister pneumosintes, and Corynebacterium suicordis could be used as the supplementary factors in the prediction of the healing status of anastomoses in CRC patients after radical resection of CRC.

Research perspectives

Our findings provided new clinical evidence for the theory that intestinal microbiota is involved in the anastomotic healing, and it contributes to the screening of potential targets for the early diagnosis and treatment of impaired anastomotic healing.