Abstract
Subtotal gastrectomy (i.e., partial removal of the stomach), a surgical treatment for early-stage distal gastric cancer, is usually accompanied by highly selective vagotomy and Billroth II reconstruction, leading to dramatic changes in the gastric environment. Based on accumulating evidence of a strong link between human gut microbiota and host health, a 2-year follow-up study was conducted to characterize the effects of subtotal gastrectomy. Gastric microbiota and predicted gene functions inferred from 16S rRNA gene sequencing were analyzed before and after surgery. The results demonstrated that gastric microbiota is significantly more diverse after surgery. Ralstonia and Helicobacter were the top two genera of discriminant abundance in the cancerous stomach before surgery, while Streptococcus and Prevotella were the two most abundant genera after tumor excision. Furthermore, N-nitrosation genes were prevalent before surgery, whereas bile salt hydrolase, NO and N2O reductase were prevalent afterward. To our knowledge, this is the first report to document changes in gastric microbiota before and after surgical treatment of stomach cancer.
Highlights
Gastrectomy for gastric cancer are often subjected to other surgical procedures, which alter the gastric environment
Are different anatomic sites inhabited by different microbes? What is the compositional variation in gastric microbiota after subtotal gastrectomy? What is the biodiversity pattern before and after subtotal gastrectomy? Do metabolic functions embedded in gastric microbiota correspond to changes caused by subtotal gastrectomy? In this study, we aimed to address these questions by deep sequencing of microbial 16S ribosomal RNA genes in gastric tissues
To characterize stomach bacterial microbiota and potential variations associated with subtotal gastrectomy, we collected tumor and non-tumor (N) tissues before surgery, as well as gastric stump (S) and high body (B) tissues after surgery, from 6 gastric cancer patients
Summary
Gastrectomy for gastric cancer are often subjected to other surgical procedures, which alter the gastric environment. There are several common side effects, including marginal ulcers, bile reflux, and stump cancer. Gastric microbiota is altered after subtotal gastrectomy[14], changes in diversity have not been well characterized. Despite characterization of gastric microbiota by culture-independent approaches, changes following subtotal gastrectomy in patients with gastric cancer are not completely understood. Do metabolic functions embedded in gastric microbiota correspond to changes caused by subtotal gastrectomy? Gastric microbiota in gastric cancer patients (at various anatomic sites and before and after subtotal gastrectomy) was characterized by 16S rRNA gene sequencing. Within the 2-year timeframe of this follow-up study, 24 gastric biopsies were collected from 6 patients subjected to subtotal gastrectomy. Variations in gastric microbiota and predicted gene functions before and after tumor excision (subtotal gastrectomy) were determined
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