Abstract
The physical status of humans can be estimated by observing the appearance of the tongue coating, known as tongue diagnosis. The goals of this study were to reveal the relationship between tongue coating appearance and the oral microbiota in patients with gastric cancer and to open a novel research direction supporting tongue diagnosis. We used a tongue manifestation acquisition instrument to analyse the thickness of the tongue coating of patients with gastric cancer and that of healthy controls, and high-throughput sequencing was used to describe the microbial community of the tongue coating by sequencing the V2–V4 region of the 16S rDNA. The tongue coatings of 74 patients with gastric cancer were significantly thicker than those of 72 healthy controls (343.11 ± 198.22 versus 98.42 ± 48.25, P < 0.001); 51.35% of the patients were assessed as having thick tongue coatings, whereas all healthy controls were assessed as having thin tongue coatings. Thick tongue coatings presented lower microbial community diversity than thin tongue coatings. The tongue coating bacterial community is associated with the appearance of the tongue coating. The tongue coating may be a potential source for diagnosing gastric cancer, but its sensitivity needs to be further improved.
Highlights
Traditional Chinese Medicine (TCM), practiced by generations of Chinese doctors for over 3000 years [1, 2], has been abundantly used in the clinic
We used the DS01-B tongue manifestation acquisition instrument to analyse the thickness of tongue coatings and found that the thickness differed between the patients and the healthy controls
To control for factors that may influence the microbiota of tongue coatings, we included BMI [21], diabetes [22], and hypertension [6], which may influence the human body microbial community, and smoking [23] and drinking [24], which may be associated with the risk of gastric cancer, in the statistical analysis
Summary
Traditional Chinese Medicine (TCM), practiced by generations of Chinese doctors for over 3000 years [1, 2], has been abundantly used in the clinic. As an essential part of TCM, tongue diagnosis estimates human physical status by observing the appearance of the tongue coating. The normal tongue is covered by a thin, white coating that is composed of bacteria, desquamated epithelial cells, leukocytes, blood metabolites, and various nutrients. When the human body is in a morbid state, with less food and chewing, the tongue coating is thicker. Tongue diagnosis has many advantages as it is noninvasive and convenient. It is not widely approved due to its subjectivity and nonreproducibility because it is primarily estimated by the naked eye by experienced TCM doctors. To eliminate the influence of artificial factors, a computer-aided tongue diagnosis system has been developed to establish a uniform standard for tongue diagnosis [3, 4]
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