Published online Dec 15, 2021. doi: 10.4251/wjgo.v13.i12.2088
Peer-review started: March 22, 2021
First decision: July 3, 2021
Revised: July 10, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: December 15, 2021
Processing time: 267 Days and 17.9 Hours
Pancreaticobiliary cancer (PB Ca) is a lethal disease; however, there are currently no appropriate diagnostic and prognostic markers. Recently, the human microbiota was reported to be a causative factor, diagnostic marker, and prognostic marker for gastrointestinal malignant diseases.
The oral and fecal microbiota have been reported to be useful diagnostic markers for gastrointestinal cancer. The duodenum is located closer to the pancreas and bile duct than the oral cavity and colon. Therefore, we hypothesized that assessment of the duodenal microbiota might improve the diagnostic accuracy for PB Ca.
To investigate the diagnostic accuracy of duodenal microbiota evaluation for PB Ca.
Thirty-four PB Ca and benign pancreaticobiliary disease patients were recruited for this study, and their duodenal juice was aseptically collected by endoscopy. The duodenal microbiota was analyzed, and the relative abundances of species in the duodenal microbiota were compared between PB Ca patients and benign pancreaticobiliary disease patients. The PB Ca diagnosability was compared between a conventional tumor marker and species in the duodenal microbiota with significantly different abundances in PB Ca patients vs benign pancreaticobiliary disease patients.
The abundances of cancer antigen 19-9 (CA19-9), Bifidobacterium, Clostridium cluster XVIII, and Prevotella were significantly different between PB Ca patients and benign pancreaticobiliary disease patients. The diagnostic capacity of Clostridium cluster XVIII was the highest among the four markers (CA19-9, Bifidobacterium, Clostridium cluster XVIII, and Prevotella). The combined assessment of Clostridium cluster XVIII and CA19-9 Levels was useful for PB Ca diagnosis.
It was possible to investigate the microbiota of duodenal juice. Duodenal microbiota evaluation may contribute to the diagnosis of PB Ca.
In the future, novel diagnostic and prognostic markers and treatments could be developed by investigating the relationship between the duodenal microbiota and PB Ca.