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Characteristics of gut microbiota in anastomotic leakage patients in cold zones post-colorectal cancer surgery: A high-throughput sequencing and propensity-score matching study
doi: 10.1515/fzm-2024-0013
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Abstract:
Objective The study aimed to explore the association between gut microbiota and anastomotic leakage (AL) after surgery in colorectal cancer (CRC) patients from a frigid zone, based on high-throughput sequencing. Methods A total of 98 CRC patients admitted to the Second Affiliated Hospital of Harbin Medical University from July 2018 to February 2019, who met the inclusion criteria, were included. Among these, 10 patients were diagnosed as AL. After propensity-score matching of baseline characteristics, 10 patients from the anastomotic leakage group (AG) and 10 patients from the normal group (NG) were finally included in this study. Fecal samples were collected, and total DNA was extracted for high-throughput sequencing and bioinformatic analysis. Results Alpha diversity analysis showed no significant difference between the two groups, while beta diversity analysis revealed significant differences in principal components. Differential microbiota were classified as Proteobacteria at the phylum level (P = 0.021). At the genus level, the abundances of Streptococcus (P = 0.045), Citrobacter (P = 0.008) and Klebsiella (P = 0.002) were significantly different between the two groups. LEfSe analysis indicated that these genera contributed most to the differences between the groups. Conclusion The characteristics of the gut microbiota in the AG and NG were significantly different, and these differences might be associated with AL in CRC patients from frigid zones. -
Key words:
- colorectal cancer /
- anastomotic leakage /
- gut microbiota
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Figure 4. Principal coordinate analysis based on operational taxonomic units (OTU) level
(A) unweighted_unifric algorithm, R = 0.207, P = 0.008; (B) weighted_unifric algorithm, R = 0.246, P = 0.012
Figure 5. Non-metric multidimensional scale analysis on different level
(A) Phylum level, stress = 0.024; (B) Class level, stress = 0.075; (C) Order level, stress =0.081; (D) Family level, stress = 0.141; (E) Genus level, stress = 0.143; (F) Species level, stress = 0.149
Table 1. Basic demographic characteristics before and after propensity score matching (PSM)
Characteristics Before PSM P value After PSM P value AG (N = 10) NG (N = 88) AG (N = 10) NG (N = 10) Gender, N (%) 0.973 0.606 Male 8 (80.0) 70 (79.5) 8 (80.0) 7 (70.0) Female 2 (20.0) 18 (20.5) 2 (20.0) 3 (30.0) Age, years, N (%) 0.193 0.653 ≥ 60 4 (40.0) 54 (61.4) 4 (40.0) 5 (50.0) < 60 6 (60.0) 34 (38.6) 6 (60.0) 5 (50.0) BMI (kg/m2), X ± s 22.7 ± 2.6 21.9 ± 3.0 0.506 22.7 ± 2.6 22.9 ± 3.1 0.844 Tumor location, N (%) 0.990 0.865 Right-sided colon 2 (20.0) 18 (20.5) 2 (20.0) 2 (20.0) Left-sided colon 3 (30.0) 28 (31.8) 3 (30.0) 2 (20.0) Rectum 5 (50.0) 42 (47.7) 5 (50.0) 6 (60.0) ASA score, N (%) 0.517 0.264 Ⅰ-Ⅱ 9 (90.0) 72 (81.8) 9 (90.0) 7 (70.0) Ⅲ-Ⅳ 1 (10.0) 16 (18.2) 1 (10.0) 3 (30.0) TNM stage, N (%) 0.583 0.654 Ⅰ 0 10 (11.4) 0 0 Ⅱ 3 (30.0) 28 (31.8) 3 (30.0) 4 (40.0) Ⅲ 6 (60.0) 37 (42.0) 6 (60.0) 4 (40.0) Ⅳ 1 (10.0) 13 (14.8) 1 (10.0) 2 (20.0) AG, anastomotic leakage group; NG, normal group; ASA, American Society of Anesthesiologists 
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Table 2. Comparison of pathological outcomes after propensity score matching
Characteristics AG (N = 10) NG (N = 10) P value T stage, N (%) 0.329 T1/T2 2 (20.0) 4 (40.0) T3/T4 8 (80.0) 6 (60.0) N stage, N (%) 0.639 N0 3 (30.0) 4 (40.0) N1/N2 7 (70.0) 6 (60.0) Tumor maximum diameter (cm), N (%) 0.264 < 5 1 (10.0) 3 (30.0) ≥ 5 9 (90.0) 7 (70.0) Grade, N (%) 0.717 Well differentiated 1 (10.0) 2 (20.0) Moderately differentiated 7 (70.0) 7 (70.0) Poor differentiated 2 (20.0) 1 (10.0) Histology, N (%) 0.136 Adenocarcinoma 8 (80.0) 10 (100.0) Other types 2 (20.0) 0
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Table 3. Alpha diversity analysis outcomes
Index name AG NG P value Simpson 0.10 ± 0.06 0.20 ± 0.16 0.089 Shannon 3.12 ± 0.61 2.58 ± 0.72 0.086 Sobs 175.70 ± 49.18 153.40 ± 42.77 0.294 Chao 193.33 ± 45.68 174.85 ± 41.48 0.356 Ace 196.06 ± 34.75 183.95 ± 44.42 0.506 AG, anastomotic leakage group; NG, normal group
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