Abstract
BackgroundThere have been previous studies associating microorganisms to cancer and with our recent findings of Blastocytsis antigen having a higher in vitro proliferation of cancer cells strengthens the suspicion. Collecting faecal samples alone to associate this parasite with cancer may not be accurate due to the phenomenon of irregular shedding and the possible treatment administrated to the cancer patients. Hence, this become the basis to search for an alternate method of sample collection. Colonic washout is an almost complete washed up material from colon and rectum which includes various microorganisms such as Blastocystis and other lodged material within the villi. The detection of parasite in colonic washouts will give a better reflection on the association between Blastocystis and CRC.MethodsBlastocytsis detection was made by in vitro culture method using Jones’ medium, formal ether concentration technique and conventional polymerase chain reaction (PCR) on faecal samples and colonic washouts of 204 CRC patients from colonoscopy procedure. Faecal samples and colonic washouts from 221 normal individuals served as control.ResultsWe observed an increased detection of Blastocystis using colonic washouts (n = 53, 12.47%) than faecal samples (n = 26, 6.12%). Eleven faecal samples showed positive results for Blastocystis which were also found in colonic washouts using the PCR technique. This study for the first time showed a significant Blastocystis infection among CRC patients (n = 43, 21.08%) compared to the asymptomatic normal individuals (n = 22, 9.95%). Blastocystis subtype 3 infection was found to be significantly more prevalent (n = 26, 12.75%) compared to other subtypes namely subtype 1: n = 9 (4.41%), subtype 2: n = 1 (0.49%), subtype 5: n = 1 (0.49%) and mixed subtype: n = 6 (2.94%) among the CRC patients.ConclusionThe study showed that colonic washouts provide a better alternative for Blastocystis detection in CRC patients compared to faecal samples as this prevents treatment regime and the phenomenon of irregular shedding from influencing the detection results obtained from faecal samples.
Highlights
There have been previous studies associating microorganisms to cancer and with our recent findings of Blastocytsis antigen having a higher in vitro proliferation of cancer cells strengthens the suspicion
Blastocystis detection in the faecal samples and colonic washouts The overall prevalence of Blastocystis infection obtained from the three methods used was 15.29% (65/425)
Forty-one colonic washouts were positive for Blastocystis, despite the faecal samples from the same patients being negative for Blastocystis
Summary
There have been previous studies associating microorganisms to cancer and with our recent findings of Blastocytsis antigen having a higher in vitro proliferation of cancer cells strengthens the suspicion. Collecting faecal samples alone to associate this parasite with cancer may not be accurate due to the phenomenon of irregular shedding and the possible treatment administrated to the cancer patients. This become the basis to search for an alternate method of sample collection. The detection of parasite in colonic washouts will give a better reflection on the association between Blastocystis and CRC. Among colorectal cancer (CRC) patients, the prevalence of Blastocystis is yet to be determined probably due to the lack of evidence to show its pathogenic role. Considering the fact that human intestine is often exposed to various microorganisms, the putative role of infectious agents in causing gastrointestinal disorders including CRC is undeniable. Human colon can allow the growth of over 500 different species of bacteria due to its environment which is rich in nutrients [4]
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