Abstract
BackgroundThe key-stone-pathogen, Porphyromonas gingivalis associates not only with periodontal diseases but with a variety of other chronic diseases such as cancer. We previously reported an association between the presence of Porphyromonas gingivalis in esophageal squamous cell carcinoma (ESCC) and its progression. We now report the diagnostic and prognostic potential of serum immunoglobulin G and A antibodies (IgG/A) against Porphyromonas gingivalis for ESCC.MethodsAn enzyme-linked immunosorbent assay (ELISA) was used to determine the serum levels of Porphyromonas gingivalis IgG and IgA in 96 cases with ESCC, 50 cases with esophagitis and 80 healthy controls.ResultsThe median serum levels of IgG and IgA for P. gingivalis were significantly higher in ESCC patients than non-ESCC controls. P. gingivalis IgG and IgA in serum demonstrated sensitivities/specificities of 29.17%/96.90% and 52.10%/70.81%, respectively, and combination of IgG and IgA produced a sensitivity/specificity of 68.75%/68.46%. The diagnostic performance of serum P. gingivalis IgA for early ESCC was superior to that of IgG (54.54% vs. 20.45%). Furthermore, high serum levels of P. gingivalis IgG or IgA were associated with worse prognosis of ESCC patients, in particular for patients with stage 0-IIor negative lymphnode metastasis, and ESCC patients with high levels of both IgG and IgA had the worst prognosis. Multivariate analysis revealed that lymph node status, IgG and IgA were independent prognostic factors.ConclusionsThe IgG and IgA for P. gingivalis are potential serum biomarkers for ESCC and combination of IgG and IgA improves the diagnostic and prognostic performance. Furthermore, serum P. gingivalis IgG and IgA can detect early stage ESCC.
Highlights
The key-stone-pathogen, Porphyromonas gingivalis associates with periodontal diseases but with a variety of other chronic diseases such as cancer
On the grounds of our recent study establishing the association between the infection of P. gingivalis in esophageal epithelium and progression of esophageal squamous cell carcinoma (ESCC), we investigate the serum levels of immunoglobulin G and A (IgG and IgA) for P. gingivalis and their clinical significance for the diagnosis and postoperative prognosis of ESCC
As there were no significant differences between healthy controls and non-ESCC patients with esophagitis with regards to serum levels of P. gingivalis IgG or IgA, we combined these two cohorts as non-ESCC controls hereafter
Summary
The key-stone-pathogen, Porphyromonas gingivalis associates with periodontal diseases but with a variety of other chronic diseases such as cancer. Accurate staging and prognosis is difficult to assess at diagnosis, which hampers ESCC tailoring therapy, treatment efficiency and recurrence monitoring. It is, imperative to identify novel biomarkers for early detection, metastasis and recurrence to reduce ESCC-related morbidity and mortality. Porphyromonas gingivalis has become regarded as a key-stone pathogen and is closely associated with periodontal diseases, a variety of presumably unrelated chronic diseases and multiple cancers [30, 31]. The self-reported tooth loss may have a microbial basis in the case of esophageal cancer [16, 17], there is no convincing evidence of direct and specific microbial etiologic agents until our recent findings, which revealed a higher frequency (61%) of P. gingivalis presence in ESCC [18]
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