Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Nov 15, 2026; 18(11): 122507
Published online Nov 15, 2026. doi: 10.4251/wjgo.122507
Published online Nov 15, 2026. doi: 10.4251/wjgo.122507
Microbial succession driven by Alistipes depletion shapes the mesenchymal and immune-excluded consensus molecular subtype 4 colorectal cancer landscape
Jian-Dong Hu, Chen-Jie Qiu, Zhen-Biao Song, Zi-Wei Xia, Hui Geng, Department of General Surgery, Changzhou Hospital of Traditional Chinese Medicine, Changzhou 213000, Jiangsu Province, China
Hai-Tao Wang, Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Soochow University, Changzhou 213000, Jiangsu Province, China
Co-corresponding authors: Hai-Tao Wang and Hui Geng.
Author contributions: Wang HT and Geng H contributed to supervision, writing - review, and editing, and they equally to this work as corresponding authors; Hu JD contributed to the conceptualization, data curation, formal analysis, and writing - original draft preparation; Wang HT contributed to the project administration; Hu JD, Qiu CJ, and Geng H contributed to investigation; Xia ZW and Song ZB contributed to validation; Song ZB contributed to the methodology; Qiu CJ and Xia ZW contributed to the resources. All authors contributed to the article and approved the submitted version.
AI contribution statement: The author declares that no AI tools were used.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Changzhou Hospital of Traditional Chinese Medicine [approval No. 2023-LL-021(L)].
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon request.
Corresponding author: Hai-Tao Wang, Professor, Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Soochow University, No. 185 Jiqian Street, Changzhou 213000, Jiangsu Province, China. 15961290078@163.com
Received: April 30, 2026
Revised: June 8, 2026
Accepted: June 25, 2026
Published online: November 15, 2026
Processing time: 179 Days and 14.2 Hours
Revised: June 8, 2026
Accepted: June 25, 2026
Published online: November 15, 2026
Processing time: 179 Days and 14.2 Hours
Core Tip
Core Tip: Consensus Molecular Subtype 4 colorectal cancer exhibits a unique microbial succession pattern. Depletion of Alistipes indistinctus initiates a cascade of pathogenic events, ultimately making Fusobacterium the dominant microbial taxon. This microbial shift may mediate tumor immune exclusion through extracellular matrix remodelling, indicating considerable potential for these microbial signatures to act as prognostic biomarkers and therapeutic targets for this refractory cancer subtype.