Data_Sheet_2_Prediction of Postoperative Ileus in Patients With Colorectal Cancer by Preoperative Gut Microbiota.DOCX

BackgroundIleus and postoperative ileus (POI) are common complications of colorectal cancer (CRC). However, little is known about the gut microbiota associated with ileus.MethodDifferences in gut microbiota were evaluated by 16S rRNA gene sequencing. We characterized the gut microbiota in 85 CRC patients (cohort 1) and detected differences, and an independent cohort composed of 38 CRC patients (cohort 2) was used to evaluate the results.ResultsThe gut microbiota of CRC patients with and without ileus exhibited large differences in alpha- and beta-diversities and bacterial taxa. The Firmicutes-to-Bacteroidetes ratio and microbial dysbiosis index (MDI) showed greater dysbiosis among ileus patients than among those without ileus. According to the location of CRC, the difference in gut microbiota between patients with and without ileus was more obvious in those with distal CRC than in those with proximal CRC. Finally, Faecalibacterium was significantly reduced in the postoperative perioperative period in patients with ileus. Thus, we used Faecalibacterium as a biomarker for predicting perioperative or POI: the AUC value was 0.74 for perioperative ileus and 0.67 for POI that appeared at 6 months after hospital discharge. The predictive power was evaluated in Cohort 2, with an AUC value of 0.79.ConclusionThese findings regarding difference of gut microbiota in postoperative CRC patients may provide a theoretical basis for the use of microbiota as biomarkers for the prediction of POI.

背景：肠梗阻和术后肠梗阻（POI）是结直肠癌（CRC）的常见并发症。然而，关于与肠梗阻相关的肠道微生物群知之甚少。方法：通过16S rRNA基因测序评估了肠道微生物群的差异。我们描述了85例CRC患者（队列1）的肠道微生物群，并发现了差异，并使用由38例CRC患者组成的独立队列（队列2）来评估结果。结果：患有和未患有肠梗阻的CRC患者的肠道微生物群在α-和β-多样性以及细菌分类上存在显著差异。与无肠梗阻患者相比，肠梗阻患者的厚壁菌门与拟杆菌门的比值和微生物失调指数（MDI）显示出更严重的失调。根据CRC的位置，与无肠梗阻患者相比，远端CRC患者的肠道微生物群差异更为明显。最后，在肠梗阻患者的围手术期，粪杆菌显著减少。因此，我们将粪杆菌作为预测围手术期或POI的生物标志物：围手术期肠梗阻的AUC值为0.74，出院后6个月出现的POI的AUC值为0.67。在队列2中评估了预测能力，AUC值为0.79。结论：关于术后CRC患者肠道微生物群差异的研究发现，可能为将微生物群作为预测POI的生物标志物的应用提供理论依据。