常见口腔细菌多，竟然和食管癌有关？

论文标题：Oral infectious bacteria in dental plaque and saliva as risk factors in patients with esophageal cancer

作者：Machiko Kawasaki, Yuichi Ikeda, Eri Ikeda, Momoko Takahashi, Daiki Tanaka, Yasuaki Nakajima, Shinichi Arakawa, Yuichi Izumi, Satoshi Miyake

期刊：Cancer

摘要：Background High levels of periodontopathic bacteria as well as Streptococcus anginosus were detected in cancer tissue from patients with esophageal cancer. An association between oral infectious bacteria and esophageal cancer has been reported. Methods Characteristics of the oral microbiota and periodontal conditions were studied as clinicopathologic factors in patients with esophageal cancer. The study included 61 patients with esophageal cancer and 62 matched individuals without any cancers. Samples of subgingival dental plaque and unstimulated saliva were collected to evaluate the prevalence and abundance of the following oral bacteria using a real‐time polymerase chain reaction assay: Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola, and S. anginosus. Results In the cancer group, the prevalence of all bacteria, with the exception of F. nucleatum, in dental plaque; the prevalence of A. actinomycetemcomitans in saliva; the abundance of all bacteria, with the exception of F. nucleatum and P. intermedia, in dental plaque; and the abundance of A. actinomycetemcomitans and S. anginosus in saliva were significantly higher. Furthermore, a logistic regression analysis suggested that the prevalence of T. forsythia and S. anginosus in dental plaque and of A. actinomycetemcomitans in saliva, as well as a drinking habit, were associated with a high risk of esophageal cancer, with a high odds ratio. Conclusions The current findings have potential implications for the early diagnosis of esophageal cancer.

人体内有着数以万计和我们共存的微生物，对健康带来广泛影响。除了肠道菌群，口腔也是我们体内大量微生物的另一处重要来源，其中可能生活着超过700种细菌。众所周知，一些口腔细菌与牙周疾病密切相关。而意外的是，近期发表于美国癌症协会（ACS）期刊Cancer的一项研究提示，部分特定病原体可能还与消化道癌症有关。

论文第一作者，东京医科牙科大学Mawaiko Kawasaki医生表示：“食管癌是全球第六大致命癌症，被发现时往往是晚期，预后普遍较差。因此，更好地了解食管癌的相关因素可能有助于早期发现。”

截图来源：Cancer

此前已有研究报道，食管癌患者的癌组织中检出了高浓度的常见口腔细菌。这项研究中，为了了解口腔病原体在消化道癌症中的作用，来自东京医科牙科大学（TMDU）研究团队收集了61例食管癌患者和62名健康对照者的牙菌斑和唾液样本进行对比。研究通过PCR技术来识别其中的细菌DNA，并重点关注7种常见牙周病原体。

数据显示，食管癌患者更普遍有吸烟和饮酒习惯，牙龈健康状况也普遍更差。但引起研究团队注意的是，在7种病原体中，癌症患者的牙菌斑中有5种都比健康对照组的丰度更高，有6种的检出率也明显更高。另一方面，癌症患者的唾液中有两种病原体含量更高，分别是伴放线杆菌聚集菌（Aggregatibacter actinomycetemcomitans）和咽峡炎链球菌（Streptococcus anginosus）。

▲癌症患者的牙菌斑样品中（左侧带红色光环的圆圈），大多细菌的检出率（饼图中红色部分）都高于健康对照组（右侧带蓝色光环的圆圈）。（图片来源：参考资料[1]）

进一步回归分析发现，牙菌斑中的咽峡炎链球菌（Streptococcus anginosus）和福赛坦氏菌 （Tannerella forsythia），唾液的伴放线杆菌聚集菌（Aggregatibacter actinomycetemcomitans），以及烟酒摄入，与食管癌风险升高有关。

研究团队提出，这些结果能够为口腔细菌检查用于食管癌筛查提供洞见。

参考资料

[1] Machiko Kawasaki, et al., (2021). Oral Infectious Bacteria in Dental Plaque and Saliva as Risk Factors in Patients With Esophageal Cancer. Cancer, DOI: 10.1002/cncr.33316.

[2] Esophageal cancer patients show abundance of oral. Retrieved January 18, 2020, from https://www.eurekalert.org/pub_releases/2021-01/tmad-ecp011421.php

https://mp.weixin.qq.com/s/ftV73trCvA24AsUOUDsy7A