Gastric microbiome signature for predicting metachronous recurrence after endoscopic resection of gastric neoplasm

• Published in: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2024-09, Vol.27 (5), p.1031-1045
• Main Authors: Lee, Ho-Kyoung, Shin, Cheol Min, Chang, Young Hoon, Yoon, Hyuk, Park, Young Soo, Kim, Nayoung, Lee, Dong Ho
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Aged; Biomarkers; Biopsy; Cancer Research; Carcinogenesis; Carcinogens; Endoscopy; Female; Follow-Up Studies; Gastric cancer; Gastric mucosa; Gastric Mucosa - microbiology; Gastric Mucosa - pathology; Gastric Mucosa - surgery; Gastritis; Gastroenterology; Gastrointestinal Microbiome; Health risks; Helicobacter Infections - microbiology; Helicobacter Infections - pathology; Helicobacter pylori - isolation & purification; Humans; Male; Medicine; Medicine & Public Health; Metaplasia; Microbiomes; Middle Aged; Neoplasm Recurrence, Local - microbiology; Neoplasm Recurrence, Local - pathology; Neoplasms, Second Primary - microbiology; Neoplasms, Second Primary - pathology; Oncology; Original Article; Phylogeny; Population studies; Prognosis; Prospective Studies; Ribosomal DNA; Stomach Neoplasms - microbiology; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgical Oncology; Tumors
• ISSN: 1436-3291; 1436-3305; 1436-3305
• DOI: 10.1007/s10120-024-01532-3

Background Changes in gastric microbiome are associated with gastric carcinogenesis. Studies on the association between gastric mucosa-associated gastric microbiome (MAM) and metachronous gastric cancer are limited. This study aimed to identify gastric MAM as a predictive factor for metachronous recurrence following endoscopic resection of gastric neoplasms. Method Microbiome analyses were conducted for 81 patients in a prospective cohort to investigate surrogate markers to predict metachronous recurrence. Gastric MAM in non-cancerous corporal biopsy specimens was evaluated using Illumina MiSeq platform targeting 16S ribosomal DNA. Results Over a median follow-up duration of 53.8 months, 16 metachronous gastric neoplasms developed. Baseline gastric MAM varied with Helicobacter pylori infection status, but was unaffected by initial pathologic diagnosis, presence of atrophic gastritis, intestinal metaplasia, or synchronous lesions. The group with metachronous recurrence did not exhibit distinct phylogenetic diversity compared with the group devoid of recurrence but showed significant difference in β-diversity. The study population could be classified into two distinct gastrotypes based on baseline gastric MAM: gastrotype 1, Helicobacter -abundant; gastrotype 2: Akkermansia -abundant. Patients in gastrotype 2 showed higher risk of metachronous recurrence than gastrotype (Cox proportional hazard analysis, adjusted hazard ratio [95% confidence interval]: 5.10 [1.09–23.79]). Conclusions Gastric cancer patients can be classified into two distinct gastrotype groups by their MAM profiles, which were associated with different risk of metachronous recurrence.