The long term effect of metabolic profile and microbiota status in early gastric cancer patients after subtotal gastrectomy

Abstract

Long term effects of subtotal gastrectomy on gut microbiota modifications with subsequent metabolic profiles are limited. We aimed to investigate and compare long-term effects of metabolic profiles and microbiota status in early gastric cancer patients post curative subtotal gastrectomy to the controls. In this cross-sectional study, we analyzed type II diabetes mellitus and metabolic syndrome occurrence in two groups: 111 patients after curative subtotal gastrectomy with Billroth II (BII) anastomosis and Roux-en-Y gastrojejuno (RYGJ) anastomosis and 344 age-sex matched controls. Fecal samples from those with BII, RYGJ, and controls were analyzed by next-generation sequencing method. Metabolic syndrome and type II diabetes mellitus occurrences were significantly lower in patients after subtotal gastrectomy with RYGJ than in controls over the long term (> 8 years) follow-up (P < 0.05). The richness and diversity of gut microbiota significantly increased after subtotal gastrectomy with RYGJ (P < 0.05). Compared with the control group, the principal component analysis revealed significant differences in bacterial genera abundance after subtotal gastrectomy with BII and RYGJ (P < 0.001). Genera of Oscillospira, Prevotella, Coprococcus, Veillonella, Clostridium, Desulfovibrio, Anaerosinus, Slackia, Oxalobacter, Victivallis, Butyrivibrio, Sporobacter, and Campylobacter shared more abundant roles both in the RYGJ group and BII groups. Early gastric cancer patients after subtotal gastrectomy with RYGJ had a lower occurrence of metabolic syndrome and type II diabetes mellitus than the controls during long term follow-up. In parallel with the metabolic improvements, gut microbial richness and diversity also significantly increased after subtotal gastrectomy with RYGJ.

Influence of gastrectomy for gastric cancer treatment on faecal microbiome and metabolome profiles

“…Higher Shannon diversity indices were conserved across the three major phyla: Firmicutes (mOTU: p=8.98×10 −7 ; MetaPhlAn2: p=2.91×10 −4 ), Actinobacteria (mOTU: p=7.69×10 −4 ; MetaPhlAn2: p=0.0419) and Bacteroidetes (mOTU: p=0.225; MetaPhlAn2: p=0.0283) (figure 2E and F). Our results were in accordance with previous studies, in that species diversity was higher in patients with postgastrectomy gastric cancer12 and obesity9 32 33 than in non-surgical participants.…”

“…Tseng et al revealed that subtotal gastrectomy altered the diversity, community composition and predicted gene functions of gastric microbiota, which associated closely with the altered gastric environment after surgery 11. Lin et al confirmed these findings by analysing the faecal microbiome over the long term after gastrectomy 12. They showed that patients with subtotal gastrectomy, and in particular Roux-en-Y gastrojejuno anastomosis, had subsequent lower occurrence of type II diabetes and metabolic syndrome than the controls.…”

Fecal microbiota profile in patients with inflammatory bowel disease in Taiwan

“…Bacterial genomic microbial DNAs was extracted for direct use in 16S rRNA gene sequencing. [17,18] The amounts and quality of isolated genomic DNA was determined with NanoDrop ND-1000 (Thermo Scienti c, Wilmington, DE, USA). Genomic DNA was stored at -80 °C prior to 16S rRNA sequencing.…”

“…Dual-indexes (barcodes) was used for each sample before sequencing and next-generation sequencing was performed by the Illumina MiSeq Desktop Sequencer following the standard protocol. [18] Data processing and statistical analysis The raw sequencing reads were assembled using FLASH v.1.2.7. [19] The quality of reads was assessed by QIIME 1.9.1 pipeline and low-quality reads (Q <20) were truncated.…”

Early Anastomositis After Stomach Resection

“…Пациенты со злокачественным образованием желудка, перенесшие субтотальную резекцию желудка по Бильрот II и в модификации по Ру, в послеоперационном периоде имели сни-жение ИМТ, уменьшение окружности талии, повышение уровня ЛПВП в сыворотке крови, снижение уровня ТГ и уровня глюкозы в сыворотке крови по сравнению с контрольной группой. У этих пациентов значительно ниже частота возникновения сахарного диабета II типа и метаболического синдрома, а также увеличение микробиота кишечника после субтотальной резекции в модификации по Ру [11]. Однако при наличии метаболического синдрома увеличение микробиоты при отсутствии адекватной перистальтической волны приводит к развитию локальной инфекции в зоне анастомоза, запуская вышеописанный каскадный механизм иммунного ответа.…”