Cancer‐associated fecal microbial markers in colorectal cancer detection

Abstract

Colorectal cancer (CRC) is the second most common cause of cancer death in the western world. An effective screening program leading to early detection of disease would severely reduce the mortality of CRC. Alterations in the gut microbiota have been linked to CRC, but the potential of microbial markers for use in CRC screening has been largely unstudied. We used a nested case–control study of 238 study subjects to explore the use of microbial markers for clbA+ bacteria harboring the pks pathogenicity island, afa‐C+ diffusely adherent Escherichia coli harboring the afa‐1 operon, and Fusobacterium nucleatum in stool as potential screening markers for CRC. We found that individual markers for clbA+ bacteria and F. nucleatum were more abundant in stool of patients with CRC, and could predict cancer with a relatively high specificity (81.5% and 76.9%, respectively) and with a sensitivity of 56.4% and 69.2%, respectively. In a combined test of clbA+ bacteria and F. nucleatum, CRC was detected with a specificity of 63.1% and a sensitivity of 84.6%. Our findings support a potential value of microbial factors in stool as putative noninvasive biomarkers for CRC detection. We propose that microbial markers may represent an important future screening strategy for CRC, selecting patients with a “high‐risk” microbial pattern to other further diagnostic procedures such as colonoscopy.

<i>Fusobacterium nucleatum</i>—The Cause of Human Colorectal Cancer

“…Our hypothetical distribution was the distribution of the necessary condition. Thus far, the data as published by Eklöf et al [35] do support our null hypothesis that an infection by Fusobacterium is a conditio sine qua non of colorectal carcinoma. In other words, without an infection by Fusobacterium no colorectal carcinoma.…”

“…The studies of Fukugaiti et al [31], Vogtmann et al [32] (two sided), Li et al [33], Amitay et al [34], Eklöf et al [35], where able to provide evidence that Fusobacterium is a necessary condition, a conditio sine qua non, of colon cancer. Con-sistent with this finding, the current study using data published by Ahn et al [30], Vogtmann et al [32] documented a significant cause effect relationship between Fusobacterium and colon cancer while the studies of Li et al [33], Amitay et al [34], Eklöf et al [35] were able to provide evidence of a highly significant cause effect relationship between Fusobacterium and colon cancer. In particular, we need to bear in mind that Li et al [33] were able within certain limits to provide evidence that Fusobacterium nucleatum is a necessary and sufficient condition of human colorectal cancer.…”

“…The data of Eklöf et al [35] of an infection by Fusobacterium and colorectal cancer are viewed in the 2 × 2 table (Table 7). The X 2 Goodness-of-Fit Test with continuity correction of a necessary condition (conditio sine qua non) known to …”

“…The data for this hypothesis test were provided by Eklöf et al [35] and are illustrated in the 2 × 2 table ( …”

Synbindin deficiency inhibits colon carcinogenesis by attenuating Wnt cascade and balancing gut microbiome

“…A striking example is our recent identification of the link between Fusobacterium nucleatum and the chemoresistance to CRC . We and others also showed that gut microbiota alone could predict CRC well, highlighting a potential clinical application of gut microbiota as a noninvasive screen strategy for early detection of CRC in population . Despite the enormous efforts and substantial progress, only minor improvements have been achieved in the clinical outcome of patients with CRC.…”