The Study On Association Between Esophagus Flora And Esophageal Carcinoma

Objective:To explore the distribution characteristics of esophagus cancer patients esophageal flora and analyze the association between esophagus cancer flora and dietary pattern or quality of life by metagenome sequencing. The potential connection between flora of esophagus and esophageal cancer is explored from microbiology aspect in order to provide scientific guidelines for the prevention and the treatment of esophageal carcinoma in Fujian province.Method:1. A total of 233 esophageal carcinoma patients by pathological diagnosis were recruited from the Fujian Provincial Cancer Hospital using the unified form. A total of53 subjects were accorded with the inclusion criteria(underwent radical surgery and antibiotics or microecologics were not used 2 mouths before surgery) were collected.Genomic DNA was isolated to explore the mucosa microflora composition of esophagus cancer and analyze the flora feature of esophageal cancer patients with different groups(different lesion, organization, living habits and clinical characteristics)conducted by 16 S r RNA gene sequence.2. Using frequency food questionnaire on dietary survey to investigate the nutritional status of esophagus cancer patients and build dietary pattern by factor analysis. To explore the potential associations between dietary pattern or dietary intake and the mocosa flora of esophagus cancer p patients by high-throughput sequencing.3. For survival patients, follow-up investigation were performed by utilizing the EORTC QLQ-C30 and QLQ-OES18 scales to learn quality of life of esophagus cancer patients and explore the possible associations between esophageal cancer patient esophageal flora and quality of life.Results:1. The esophageal flora of esophagus squamous cell cancer(ESCC) patients varies with the individuals.The bacteria could be mainly divided into four phyla: Proteobacteria,Firmicutes, Bacteroidetes and Fusobacteria. From the genus point of view, the flora are mainly from Prevotella, Fusobacterium, Streptococcus, Delftia, Klebsiella, Serratia and some unclassified types. As for normal esophagus mucosa, the flora are mainly from unclassified types, Prevotella and Streptococcus. Regarding to ESCC esophageal flora,there are no significant differences in different lesion areas(P>0.05). ESCC and normal esophagus mocosa showed significant differences in terms of alpha diversity, and flora diversity in the former was markedly lower than that in the latter(P<0.05). As for the different pathological type, the core member of bacterial community varies, esophagus adenocarcinoma(EAD), Proteobacteria is the highest abundance, followed by Firmicutes,ESCC own different distribution as Firmicutes highest abundance, followed by Proteobacteria. The patients with positive lymph nodes were significantly more likely to be found higher abundence of Bacteroidetes and lower abundence of Firmicutes in comparison with the patients without lymph node spread(P<0.05).2. Smoking has influence on ESCC patients esophageal flora, while the other daily habits, like drinking and tea drinking, have no significant effects. Compared with non-smokers, smokers tend to perform lower abundence of Firmicutes and Bacteroidetes(P<0.05).3. Cereal adequate intake group and low intake group showed significant differences in terms of flora diversity, and the latter was markedly lower than the former(P<0.05).Compared to proper intake, the abundance of Spirochaetae were significantly increased in too much or too little eggs intake groups. Vegetable intake has an effect on esophagus cancer esophageal flora, while the other dietary factors(beans, fruit, meat, fish and shrimp intake) have no effects. Compared to intake adequate vegetable group, low vegetable showed higher level of Antinobacteria, Acidobacteria and Chloroflexi(P<0.05). Five dietary patterns were identified, including animal-plant protein pattern, fiber pattern, unhealthy lifestyle pattern, milk pattern and coastal dietary pattern. Dietary pattern can affect esophagus cancer flora. Compared with low-score group, coastal dietary pattern was significant lower in term of flora diversity in high-score group(P<0.05), with the abundance of Bacteroidetes increasing, while Proteobacteria and Thermotogae decreasing. The abundance of Antinobacteria of animal-plant protein pattern in low-score group increase obviously compared with high-score group(P<0.05).4. There are no statistic significant difference in esophageal flora of esophagus carcinoma among diverse quality of life of patients.(P>0.05).Conclusion:1. The esophageal flora of ESCC patients varies with the individuals. The most of esophagus cancer patients esophageal bacteria could be mainly divided into four phyla:Proteobacteria, Firmicutes, Bacteroidetes and Fusobacteria. From the genus point of view, the flora are mainly from Prevotella, Fusobacterium, Streptococcus, Delftia,Klebsiella, Serratia, Treponema, Lactobacillus and some unclassified types.2. As for esophageal flora, ESCC is different from normal esophagus mucosa,esophagus cancer patients esophageal flora exist diversity reduction and dysbacteriosis.Esophageal flora may play a role in esophagus carcinoma.3. Different lesion area performed similar ESCC patients esophageal flora.4. Lymph node metastasis status, tumor morphotype and smoking have influence on the ESCC patients esophageal flora.5. Both dietary pattern and dietary factor can affect microbial community structure of ESCC patients.6. The ESCC patients esophageal flora is not related to quality of life.