Ann Surg Treat Res.  2020 Jul;99(1):44-51. 10.4174/astr.2020.99.1.44.

The effect of curative resection on fecal microbiota in patients with colorectal cancer: a prospective pilot study

• Park SS
• Kim B
• Kim MJ
• Roh SJ
• Park SC
• Kim BC
• Han KS
• Hong CW
• Sohn DK
• Oh JH

• KMID: 2503459
• DOI: http://doi.org/10.4174/astr.2020.99.1.44

Abstract

Purpose
Although many studies have evaluated the association between intestinal microorganisms and the risk of colorectal cancer (CRC), only a few studies have investigated the changes in microorganisms following curative treatment for CRC. The current study analyzed changes in intestinal microbiota following curative surgery in CRC patients.
Methods
Stool samples were collected before and 6 months after surgery, from 11 patients with clinical stage III CRC, who underwent curative surgery between May 2017 and June 2017. Next, 16S rRNA gene sequencing was performed. Operational taxonomic units (OTUs) and alpha diversity were evaluated using the Shannon index. The bacterial compositions of the stools were analyzed according to taxonomic rank at genus and phylum levels.
Results
OTUs and alpha diversity were significantly decreased following surgery (P < 0.001 and P = 0.019, respectively). The compositions of several bacterial taxa changed after surgery. At genus level, proportions of pathogens such as Campylobacter, Fusobacterium, Haemophilus, Porphyromonas, and Prevotella, decreased after surgery (adjusted P < 0.05). At phylum level, the proportion of Fusobacteria decreased after surgery (adjusted P < 0.001).
Conclusion
Significant changes in intestinal microbial communities were noted following curative resection of CRC patients. Especially, decreases in pathogenic bacterial populations, such as Fusobacterium and Prevotella, which are known to be associated with CRC development, were detected even though OTUs and alpha diversity were decreased following curative resection. To determine and validate the clinical significance of these findings, large scale, prospective studies that include cancer prognoses are required.

Keyword

Colorectal neoplasms; Gut microbiota; Surgery

Figure

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  Fig. 1 Operational taxonomic units (OTUs) and alpha diversity. (A) The number of OTUs in postoperative stool samples was significantly smaller than preoperative stool samples (preoperative vs. postoperative = median 7,920 (3,201–13,025) vs. 2,981 (2,195–10,002), P < 0.001). (B) The alpha diversity (Shannon Index) in postoperative stool samples was also significantly lower than preoperative stool samples (preoperative vs. postoperative = mean 4.16 ± 0.51 vs. 3.68 ± 0.37, P = 0.019).

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  Fig. 2 Beta diversity. Principal component analysis (PCA) plot for beta diversity showed a differential pattern between preoperative and postoperative stool samples.

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  Fig. 3 Heatmap of the micro biota which showed the statistically significant difference at genus level between preoperative and postoperative stool sample. Changes in microbiota composition after surgery at genus level were observed. G2–G12, preoperative stool sample; G2.2–G12.2, postoperative stool sample.

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  Fig. 4 Bar plot of the microbiota which showed the statistically significant difference between preoperative and postoperative stool sample at genus level. Pathogens including Prevotella and Fusobacterium, which are known to be associated with colorectal cancer development were significantly reduced after surgery. G2–G12, preoperative stool sample; G2.2–G12.2, postoperative stool sample.

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