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Vol. 57. Issue 11.
Pages 681-689 (November 2021)
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Vol. 57. Issue 11.
Pages 681-689 (November 2021)
Original Article
Core Microbiota in Central Lung Cancer With Streptococcal Enrichment as a Possible Diagnostic Marker
Núcleo de microbiota en el cáncer de pulmón central con enriquecimiento estreptocócico como posible marcador de diagnóstico
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Salvador Belloa,
Corresponding author
sbello@salud.aragon.es

Corresponding author.
, José J. Vengoecheaa, Manuel Ponce-Alonsob, Ana L. Figueredoa, Elisa Mincholéa, Antonio Rezustac, Paula Gambód, Juan Manuel Pastore, Javier Galeanoe, Rosa del Campob,f
a Department of Pulmonary Medicine, Miguel Servet University Hospital, CIBERES, Instituto de Investigación Sanitaria (ISS) Aragón, Zaragoza, Spain
b Department of Microbiology, Ramón y Cajal Health Investigation Institute (IRYCIS), Ramón y Cajal University Hospital, Madrid, Spain
c Department of Microbiology, Miguel Servet University Hospital, Instituto de Investigación Sanitaria (ISS) Aragón, Zaragoza, Spain
d Department of Pathology, Miguel Servet University Hospital, Instituto de Investigación Sanitaria (ISS) Aragón, Zaragoza, Spain
e Complex Systems Group, Universidad Politécnica de Madrid, Madrid, Spain
f University Alfonso X El Sabio, Villanueva de la Cañada, Madrid, Spain
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Table 1. Demographic and clinical data of patients with lung cancer and healthy controls, differentiating between the entire control population (n=16) and those included in the analysis of bacteria and fungi (n=12).
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Abstract
Background

Dysbiosis in lung cancer has been underexplored. The aim of this study was to define the bacterial and fungal microbiota of the bronchi in central lung cancer and to compare it with that of the oral and intestinal compartments.

Methods

Twenty-five patients with central lung cancer and sixteen controls without antimicrobial intake during the previous month were recruited. Bacterial and fungal distribution was determined by massive sequencing of bronchial biopsies and saliva and faecal samples. Complex computational analysis was performed to define the core lung microbiota.

Results

Affected and contralateral bronchi of patients have almost identical microbiota dominated by Streptococcus, whereas Pseudomonas was the dominant genera in controls. Oral and pulmonary ecosystems were significantly more similar in patients, probably due to microaspirations. Streptococcal abundance in the bronchi differentiated patients from controls according to a ROC curve analysis (90.9% sensitivity, 83.3% specificity, AUC=0.897). The saliva of patients characteristically showed a greater abundance of Streptococcus, Rothia, Gemella and Lactobacillus. The mycobiome of controls (Candida) was significantly different from that of patients (Malassezia). Cancer patients’ bronchial mycobiome was similar to their saliva, but different from their contralateral bronchi.

Conclusions

The central lung cancer microbiome shows high levels of Streptococcus, and differs significantly in its composition from that of control subjects. Changes are not restricted to tumour tissue, and seem to be the consequence of microaspirations from the oral cavity. These findings could be useful in the screening and even diagnosis of this disease.

Keywords:
Microbiome
Bronchoscopy
Lung cancer
Microaspirations
Streptococcus
Abbreviations:
ASV
AUC
COPD
FISABIO
IL
LDA
LEfSE
PCoA
PERMANOVA
QIIME
ROC
Resumen
Antecedentes

La disbiosis en cáncer pulmonar no ha sido suficientemente estudiada. Los objetivos de este estudio fueron definir la microbiota bacteriana y fúngica de bronquios con cáncer central de pulmón, y compararla con la del compartimento intestinal en heces y saliva.

Métodos

Se reclutaron 25 pacientes con cáncer central de pulmón y 16 controles sin exposición antibiótica durante el mes anterior. Se determinó la composición de bacterias y hongos en biopsias de bronquio, saliva y heces. Se realizó un análisis computacional para definir el núcleo de microbiota del pulmón.

Resultados

Los bronquios afectados y contralaterales de pacientes presentaron una microbiota similar dominada por Streptococcus, mientras que Pseudomonas destacó en los controles. Los ecosistemas orales y pulmonares fueron significativamente más parecidos en pacientes, probablemente debido a microaspiraciones. La abundancia bronquial de estreptococos permitió diferenciar a los pacientes de los controles mediante una curva ROC (90,9% de sensibilidad, 83,3% de especificidad, AUC=0,897). La saliva de los pacientes presentó mayor abundancia de Streptococcus, Rothia, Gemella y Lactobacillus. El micobioma de los controles (Candida) fue significativamente diferente al de los pacientes (Malassezia), con los bronquios afectados por el cáncer similares a su saliva, pero diferentes de sus bronquios contralaterales.

Conclusiones

En el cáncer de pulmón central hay enriquecimiento de Streptococcus, y su composición es significativamente diferente de sujetos control. Las alteraciones no se limitan al tejido tumoral, y parecen ser consecuencia de microaspiraciones desde la cavidad oral. Estos hallazgos podrían ser útiles para la detección e incluso el diagnóstico de esta patología.

Palabras clave:
Microbioma
Broncoscopia
Cáncer de pulmón
Microaspiraciones
Streptococcus

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