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      Liver cirrhosis contributes to the disorder of gut microbiota in patients with hepatocellular carcinoma

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          Abstract

          Background

          Gut microbiota (GM) of patients with liver cancer is disordered, and syet no study reported the GM distribution of liver cirrhosis‐induced HCC (LC‐HCC) and nonliver cirrhosis‐induced HCC (NLC‐HCC). In this study, we aimed to characterize gut dysbiosis of LC‐HCC and NLC‐HCC to elucidate the role of GM in the pathogenesis of HCC.

          Methods

          A consecutive series of fecal samples of patients with hepatitis (24 patients), liver cirrhosis (24 patients), HCC (75 patients: 35 infected by HBV, 25 infected by HCV, and 15 with alcoholic liver disease), and healthy controls (20 patients) were obtained and sequenced on the Illumina Hiseq platform. The HCC group contains 52 LC‐HCC and 23 NLC‐HCC. Bioinformatic analysis of the intestinal microbiota was performed with QIIME and MicrobiomeAnalyst.

          Results

          Alpha‐diversity analysis showed that fecal microbial diversity was significantly decreased in the LC group, and there were significant differences in 3 phyla and 27 genera in the LC group vs the other groups (the healthy, hepatitis, and HCC groups). Beta‐diversity analysis showed that there were large differences between LC and the others. Gut microbial diversity was significantly increased from LC to HCC. Characterizing the fecal microbiota of LC‐HCC and NLC‐HCC, we found that microbial diversity was increased from LC to LC‐HCC rather than NLC‐HCC. Thirteen genera were discovered to be associated with the tumor size of HCC. Three biomarkers ( Enterococcus, Limnobacter, and Phyllobacterium) could be used for precision diagnosis. We also found that HBV infection, HCV infection, or ALD (alcoholic liver disease) was not associated with intestinal microbial dysbiosis in HCC.

          Conclusion

          Our results suggest that GM disorders are more common in patients with LC‐HCC. The butyrate‐producing genera were decreased, while genera producing‐lipopolysaccharide (LPS) were increased in LC‐HCC patients. Further studies of GM disorders may achieve early diagnosis and new therapeutic approaches for HCC patients.

          Abstract

          Our results suggest that butyrate‐producing genera were decreased, while LPS‐producing genera were increased in LC‐HCC patients. We demonstrated that gut microbial dysbiosis in patients with HCC is associated with LC but not HBV, HCV, or ALD. We also found that four biomarkers could be used for the precise diagnosis of HCC. This study opens an avenue to the development of novel probiotics, which might help combat the aggravation of liver diseases. Furthermore, further studies of gut microbial dysbiosis may achieve early diagnosis and new therapeutic approaches for HCC patients.

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          Most cited references28

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          Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics?

          Cancer is the leading cause of death in China and depicting the cancer pattern of China would provide basic knowhows on how to tackle it more effectively. In this study we have reviewed several reports of cancer burden, including the Global cancer statistics 2018 and Cancer statistics in China, 2015, along with the GLOBCAN 2018 online database, to investigate the differences of cancer patterns between China, the United States (USA) and the United Kingdom (UK). An estimated 4.3 million new cancer cases and 2.9 million new cancer deaths occurred in China in 2018. Compared to the USA and UK, China has lower cancer incidence but a 30% and 40% higher cancer mortality than the UK and USA, among which 36.4% of the cancer-related deaths were from the digestive tract cancers (stomach, liver, and esophagus cancer) and have relatively poorer prognoses. In comparison, the digestive cancer deaths only took up ≤ 5% of the total cancer deaths in either USA or UK. Other reasons for the higher mortality in China may be the low rate of early-stage cancers at diagnosis and non-uniformed clinical cancer treatment strategies performed by different regions. China is undergoing the cancer transition stage where the cancer spectrum is changing from developing country to developed country, with a rapidly increase cancer burden of colorectal, prostate, female breast cancers in addition to a high occurrence of infection-related and digestive cancers. The incidence of westernized lifestyle-related cancers in China (i.e. colorectal cancer, prostate, bladder cancer) has risen but the incidence of the digestive cancers has decreased from 2000 to 2011. An estimated 40% of the risk factors can be attributed to environmental and lifestyle factors either in China or other developed countries. Tobacco smoking is the single most important carcinogenic risk factor in China, contributing to ~ 24.5% of cancers in males. Chronic infection is another important preventable cancer contributor which is responsible for ~ 17% of cancers. Comprehensive prevention and control strategies in China should include effective tobacco-control policy, recommendations for healthier lifestyles, along with enlarging the coverage of effective screening, educating, and vaccination programs to better sensitize greater awareness control to the general public.
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            The gut microbiome and liver cancer: mechanisms and clinical translation

            Increasing evidence suggests that the gut microbiota are important modulators of chronic liver disease progression and the development of hepatocellular carcinoma. In this Review, Yu and Schwabe discuss the mechanisms by which the gut microbiota promote hepatocarcinogenesis, and explore therapeutic interventions with clinical potential.
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              Epidemiological Features of NAFLD From 1999 to 2018 in China

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                Author and article information

                Contributors
                wf@jlu.edu.cn
                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                12 April 2020
                June 2020
                : 9
                : 12 ( doiID: 10.1002/cam4.v9.12 )
                : 4232-4250
                Affiliations
                [ 1 ] Department of Pathogen Biology College of Basic Medical Sciences Jilin University Changchun China
                [ 2 ] Department of Interventional Therapy The First Hospital of Jilin University Changchun, Jilin China
                Author notes
                [*] [* ] Correspondence

                Fang Wang, Department of Pathogen Biology, College of Basic Medical Sciences, Jilin University, Changchun 130021, China.

                Email: wf@ 123456jlu.edu.cn

                Author information
                https://orcid.org/0000-0003-0871-3454
                Article
                CAM43045
                10.1002/cam4.3045
                7300425
                32281295
                cb852004-3168-4e08-8448-1c92aaabe54d
                © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 November 2019
                : 20 February 2020
                : 17 March 2020
                Page count
                Figures: 13, Tables: 1, Pages: 19, Words: 8240
                Funding
                Funded by: Fundamental Research Funds for the Central Universities
                Funded by: Provincial School Co‐construction Industrialization Demonstration Project of Jilin Province
                Award ID: SXGJSF2017‐1‐1(01)
                Funded by: Graduate Innovation Fund of Jilin University
                Award ID: 101832018C060
                Categories
                Original Research
                Cancer Biology
                Original Research
                Custom metadata
                2.0
                June 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.4 mode:remove_FC converted:18.06.2020

                Oncology & Radiotherapy
                gut microbiota,hepatitis,hepatocellular carcinoma,liver cirrhosis
                Oncology & Radiotherapy
                gut microbiota, hepatitis, hepatocellular carcinoma, liver cirrhosis

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