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Esophageal bacteria may be linked to esophageal squamous cell carcinoma
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Researchers have demonstrated that the presence of the pathogen Porphyromonas gingivalis in esophageal mucosa may be associated with an increased risk for esophageal squamous cell carcinoma.
“These findings provide the first direct evidence that P. gingivalis infection could be a novel risk factor for [esophageal squamous cell carcinoma], and may also serve as a prognostic biomarker for this type of cancer,” Huizhi Wang, MD, PhD, assistant professor of oral immunology and infectious diseases at the University of Louisville School of Dentistry in Kentucky, said in a press release. “These data, if confirmed, indicate that eradication of a common oral pathogen may contribute to a reduction in the significant number of people suffering with [esophageal squamous cell carcinoma].”
Wang and colleagues evaluated esophageal tissue samples from 100 patients with esophageal squamous cell carcinoma (ESCC) and 30 normal matched controls. They aimed to determine the presence of P. gingivalis by immunohistochemistry using antibodies targeting whole bacteria and lysine-gingipain, an enzyme unique to P. gingivalis. They also used quantitative reverse transcription-polymerase chain reaction, or qRT-PCR, to detect 16S rDNA.
P. gingivalis was present in 61% of cancerous tissues and 12% of adjacent tissues, but was not detected in normal esophageal mucosa (both comparisons, P < .01). Lysine-gingipain and 16S rDNA were comparably distributed in the cancerous and adjacent tissues vs. normal mucosa (both P < .01 and P < .001, respectively).
P. gingivalis infection was also found to be positively correlated with clinicopathologic characteristics of ESCC. “While the presence of P. gingivalis was not significantly associated with age, gender, or smoking history of the patients, [it] was positively related to differentiation, lymph node metastasis and the TNM stage of ESCC (P < .05),” the researchers wrote.
Survival analysis over 30 months showed P. gingivalis was also associated with lower overall survival in ESCC patients (P = .036).
The researchers concluded that their findings establish the presence of P. gingivalis molecules in the esophageal epithelium of patients with ESCC, “and provide the first direct evidence of a positive correlation between P. gingivalis infection, ESCC severity and poor prognosis.” Infection with this pathogen could be a biomarker for ESCC, they added.
“Should P. gingivalis prove to cause ESCC, the implications are enormous,” Wang said in the press release. “It would suggest that improving oral hygiene may reduce ESCC risk; screening for P. gingivalis in dental plaque may identify susceptible subjects; and using antibiotics or other antibacterial strategies may prevent ESCC progression.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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