Fusobacterium nucleatum in colorectal carcinoma tissue and patient prognosis

This research was originally published in 2016 by Kosuke Mima, Reiko Nishihara, Zhi Rong Qian, Yin Cao, Yasutaka Sukawa, Jonathan A Nowak, Juhong Yang, Ruoxu Dou, Yohei Masugi, Mingyang Song, Aleksandar D Kostic, Marios Giannakis, Susan Bullman, Danny A Milner, Hideo Baba, Edward L Giovannucci, Levi A Garraway, Gordon J Freeman, Glenn Dranoff, Wendy S Garrett, Curtis Huttenhower, Matthew Meyerson, Jeffrey A Meyerhardt, Andrew T Chan, Charles S Fuchs, Shuji Ogino. 

We have curated this article as a reference point for The Larkin Protocol.


ABSTRACT

Objective Accumulating evidence links the intestinal microbiota and colorectal carcinogenesis. Fusobacterium nucleatum may promote colorectal tumour growth and inhibit T cell-mediated immune responses against colorectal tumours. Thus, we hypothesised that the amount of F. nucleatum in colorectal carcinoma might be associated with worse clinical outcome.

Design We used molecular pathological epidemiology database of 1069 rectal and colon cancer cases in the Nurses’ Health Study and the Health Professionals Follow-up Study, and measured F. nucleatum DNA in carcinoma tissue. Cox proportional hazards model was used to compute hazard ratio (HR), controlling for potential confounders, including microsatellite instability (MSI, mismatch repair deficiency), CpG island methylator phenotype (CIMP), KRASBRAF, and PIK3CA mutations, and LINE-1 hypomethylation (low-level methylation).

Results Compared with F. nucleatum-negative cases, multivariable HRs (95% CI) for colorectal cancer-specific mortality in F. nucleatum-low cases and F. nucleatum-high cases were 1.25 (0.82 to 1.92) and 1.58 (1.04 to 2.39), respectively, (p for trend=0.020). The amount of F. nucleatum was associated with MSI-high (multivariable odd ratio (OR), 5.22; 95% CI 2.86 to 9.55) independent of CIMP and BRAF mutation status, whereas CIMP and BRAF mutation were associated with F. nucleatum only in univariate analyses (p<0.001) but not in multivariate analysis that adjusted for MSI status.

Conclusions The amount of F. nucleatum DNA in colorectal cancer tissue is associated with shorter survival, and may potentially serve as a prognostic biomarker. Our data may have implications in developing cancer prevention and treatment strategies through targeting GI microflora by diet, probiotics and antibiotics.



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