Abstract

BackgroundGastric cancer is the third leading cause of cancer-related deaths worldwide and has been associated with infections that may promote tumour progression. Accordingly, we analysed the presence of Mollicutes, Mycoplasma hyorhinis, Fusobacterium nucleatum and Helicobacter pylori in gastric cancer tissues and evaluated their correlation with clinicopathological factors. MethodsUsing a commercial kit, DNA were extracted from 120 gastric samples embedded in paraffin: 80 from patients with gastric cancer and 40 from cancer free patients, dating from 2006 to 2016. Mollicutes and H. pylori were detected by PCR; F. nucleatum and M. hyorhinis were detected by qPCR, together with immunohistochemistry for the latter bacteria.ResultsMollicutes were detected in the case and control groups (12% and 2.5%) and correlated with the papillary histologic pattern (P = 0.003), likely due to cell transformation promoted by Mollicutes. M. hyorhinis was detected in the case and control group but was not considered a cancer risk factor. H. pylori was detected at higher loads in the case compared to the control group (8% and 22%, P = 0.008) and correlated with metastasis (P = 0.024), lymphatic invasion (P = 0.033), tumour of diffused type (P = 0.028), and histopathological grading G1/G2 (P = 0.008). F. nucleatum was the most abundant bacteria in the case group, but was also detected in the control group (26% and 2.5%). It increased the cancer risk factor (P = 0.045, OR = 10.562, CI95% = 1.057–105.521), and correlated with old age (P = 0.030) and tumour size (P = 0.053). Bacterial abundance was significantly different between groups (P = 0.001).ConclusionOur findings could improve the control and promote our understanding of opportunistic bacteria and their relevance to malignant phenotypes.

Highlights

  • Gastric cancer is the third leading cause of cancer-related deaths worldwide and has been associated with infections that may promote tumour progression

  • Extraction Method 1 (EM1), Extraction Method 2 (EM2), and Extraction Method 6 (EM6) showed the best results according to DNA quantity (2.12, 2.10, and 2.09, respectively) and purity ratios (1.91, 1.92, and 1.98, respectively)

  • Our findings indicate that formalin‐fixed paraffin‐embedded (FFPE) tissue samples improved our previous understanding with regards to the strength of association of Mollicutes, M. hyorhinis, F. nucleatum, and H. pylori in gastric cancer

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Summary

Introduction

Gastric cancer is the third leading cause of cancer-related deaths worldwide and has been associated with infections that may promote tumour progression. Gastric cancer is the fifth most diagnosed and the third leading cause of cancer-related deaths. In Brazil, mortality rates due to gastric cancer rank fourth among men and sixth among women [1, 2]. Gastric cancer affects different sites in the stomach with macroscopic variations and distinct histological patterns. The development of stomach tumours has primarily been associated with an individual’s genetics, environmental factors, and infection with pathogens that induce persistent inflammation. Helicobacter pylori is a pathogen that induces peptic ulcers, neutralises gastric acid, and, with their cag pathogenicity island, maintains a tumour-permissive microenvironment in the gastric mucosa [4]

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