Fusobacterium nucleatum in the colorectum, and its association with cancer risk and survival: a systematic review and meta-analysis
A partir d'une revue systématique de la littérature publiée jusqu'en janvier 2019 (45 études), cette méta-analyse évalue la prévalence de Fusobacterium nucleatum dans les tumeurs colorectales puis analyse l'association entre cette bactérie, le risque de cancer colorectal et la survie associée
Background: The gut microbiome, in particular Fusobacterium nucleatum, has been reported to play a role in colorectal cancer development and in patient prognosis. We aimed to perform a systematic review and meta-analysis of published studies to assess the prevalence of F. nucleatum in colorectal tumours, and evaluate the association between F. nucleatum and colorectal cancer development and prognosis. Methods: MEDLINE, EMBASE and Web of Science databases were systematically searched for studies published until January 2019. Random effects meta-analyses were used to assess the prevalence of F. nucleatum in colorectal cancer patients or tissues relative to controls and survival in F. nucleatum positive versus negative patients. Results: Forty five relevant articles were identified. Meta-analyses indicated higher odds of F. nucleatum being present in colorectal tissue samples from colorectal cancer patients (n=6 studies, pooled OR 10.06, 95% CI: 4.48-22.58) and individuals with colorectal polyps (n=5 studies, pooled OR=1.83, 95% CI: 1.07-3.16) compared to healthy controls. Similar results were apparent in faecal samples, and when comparing tumour to adjacent normal tissue. Meta-analyses indicated poorer survival in colorectal cancer patients with high versus low F. nucleatum abundance (n=5 studies, pooled HR= 1.87, 95% CI: 1.12-3.11). Conclusions: A consistent increase in the prevalence and/or abundance of F. nucleatum in colorectal cancer tissue and faecal samples compared with controls was apparent. High abundance of F. nucleatum in colorectal tumours was also associated with poorer overall survival. Impact: F. nucleatum could be useful as a diagnostic and prognostic marker for colorectal cancer or as a treatment target.