Abstract
BackgroundIt is clear that specific intestinal bacteria are involved in the development of different premalignant conditions along the gastrointestinal tract. An analysis of the microbial constituents in the context of pancreatic cystic lesions has, however, as yet not been performed. This consideration prompted us to explore whether endoscopically obtained pancreatic cyst fluids (PCF) contain bacterial DNA and to determine the genera of bacteria present in such material.MethodsTotal DNA was isolated from 69 PCF samples. Bacterial 16S rRNA gene-specific PCR was performed followed by Sanger sequencing and de novo deep sequencing for the V3-V4 variable region of 16S rRNA gene.ResultsWe observed that 98.2% of the samples were positive in conventional PCR, and that 100% of selected PCF samples (n = 33) were positive for bacterial microbiota as determined by next generation sequencing (NGS). Comprehensive NGS data analysis of PCF showed the presence of 408 genera of bacteria, of which 17 bacterial genera were uniquely abundant to PCF, when compared to the Human Microbiome Project (HMP) database and 15 bacterial microbiota were uniquely abundant in HMP only. Bacteroides spp., Escherichia/Shigella spp., and Acidaminococcus spp. which were predominant in PCF, while also a substantial Staphylococcus spp. and Fusobacterium spp. component was detected.ConclusionThese results reveal and characterize an apparently specific bacterial ecosystem in pancreatic cyst fluid samples and may reflect the local microbiota in the pancreas. Some taxa with potential deleterious functions are present in the bacterial abundance profiles, suggesting that the unique microbiome in this specific niche may contribute to neoplastic processes in the pancreas. Further studies are needed to explore the intricate relationship between pathophysiological status in the host pancreas and its microbiota.
Highlights
It is clear that specific intestinal bacteria are involved in the development of different premalignant conditions along the gastrointestinal tract
It is assumed that IPMN and mucinous cystic neoplasms (MCN) pose a higher risk of developing into carcinoma, with IPMN being more prevalent compared with MCN [1, 6]
As specific bacteria are associated with this body site, we propose that such bacteria may carry the potential to influence the development of pathophysiological processes in the pancreas
Summary
It is clear that specific intestinal bacteria are involved in the development of different premalignant conditions along the gastrointestinal tract. Grutzmann et al and Farrell et al have attempted to classify the different types of pancreatic cyst lesions and distinguish among others as intra-ductal papillary mucinous neoplasms. A set of preoperative biochemical analyses have been increasingly used in clinical decision-making This includes the study of cyst fluids and serum for the characteristic presence of carcinoembryonic antigen (CEA), cancer antigen 19.9 (CA19.9), cancer antigen 72.4 (CA72.4), cancer antigen 15.3 (CA15.3), pancreatic amylase, and mucin antigens, along with other cyst characteristics [11, 12]. Increased insight into the factors that facilitate the development of cystic lesions would benefit the identification of tests capable of providing guidance for clinical management of asymptomatic patients exhibiting pancreatic cysts
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