Fecal Signatures of Streptococcus anginosus and Streptococcus constellatus for Noninvasive Screening and Early Warning of Gastric Cancer

作者：Zhou, Cheng-Bei; Pan, Si-Yuan; Jin, Peng; Deng, Jia-Wen; Xue, Jin-Hui; Ma, Xin-Yue; Xie, Yuan-Hong; Cao, Hui; Liu, Qiang; Xie, Wei-Fen; Zou, Xiao-Ping; Sheng, Jian-Qiu; Wang, Bang-Mao; Wang, Hong; Ren, Jian-Lin; Liu, Si-De; Sun, Yun-Wei; Meng, Xiang-Jun; Zhao, Gang; Chen, Jin-Xian; Cui, Yun; Wang, Pei-Qin; Guo, Hui-Min; Yang, Lang; Chen, Xin; Ding, Jia; Yang, Xiao-Ning; Wang, Xin-Ke; Qian, Ai-Hua; Hou, Li-Dan; Wang, Zheng; Chen, Ying-Xuan; Fang, Jing-Yuan

来源：Gastroenterology, 2022, 162(7): 1933-+.

DOI：10.1053/j.gastro.2022.02.015

• Streptococcus anginosus
• Streptococcus constellatus
• Gastric Cancer
• Gastric Microbiota
• Fecal Signature

BACKGROUND & AIMS: Most patients with gastric cancer (GCa) are diagnosed at an advanced stage. We aimed to investigate novel fecal signatures for clinical application in early diagnosis of GCa. METHODS: This was an observational study that included 1043 patients from 10 hospitals in China. In the discovery cohort, 16S ribosomal RNA gene analysis was performed in paired samples (tissues and feces) from patients with GCa and chronic gastritis (ChG) to determine differential abundant microbes. Their relative abundances were detected using quantitative real-time polymerase chain reaction to test them as bacterial candidates in the training cohort. Their diagnostic efficacy was validated in the validation cohort. RESULTS: Significant enrichments of Streptococcus anginosus (Sa) and Streptococcus constellatus (Sc) in GCa tumor tissues (P < .05) and feces (P < .0001) were observed in patients with intraepithelial neoplasia, early and advanced GCa. Either the signature parallel test SaUSc or single signature Sa/Sc demonstrated superior sensitivity (Sa: 75.6% vs 72.1%, P < .05; Sc: 84.4% vs 64.0%, P < .001; and SaUSc: 91.1% vs 81.4%, P < .01) in detecting early GCa compared with advanced GCa (specificity: Sa: 84.0% vs 83.9%, Sc: 70.4% vs 82.3%, and SaU Sc: 64.0% vs 73.4%). Fecal signature Sa U Sc outperformed Sa U CEA/Sc U CEA in the discrimination of advanced GCa (sensitivity: 81.4% vs 74.2% and 81.4% vs 72.3%, P < .01; specificity: 73.4% vs 81.0 % and 73.4% vs 81.0%). The performance of SaUSc in the diagnosis of both early and advanced GCa was verified in the validation cohort. CONCLUSION: Fecal Sa and Sc are noninvasive, accurate, and sensitive signatures for early warning in GCa.

• 单位
  厦门大学; 南京大学; 南方医科大学; 1; 上海交通大学; 中山大学; 复旦大学