期刊
JOURNAL OF INFECTIOUS DISEASES
卷 224, 期 7, 页码 1247-1256出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab068
关键词
HIV; HPV; anal cancer; dysplasia; microbiota
资金
- Instituto de Salud Carlos III (Plan Estatal de I+D+i 2013-2016) [PI15/00345, PI18/00154]
- European Development Regional Fund (A way to achieve Europe)
- Fundacion Asociacion Espanola Contra el Cancer within the ERANET TRANSCAN-2 program [AC17/00022]
- Instituto de Salud Carlos III
This study identified specific anal-associated bacteria indicative of a higher risk of precancerous anal lesions, with a combination showing high diagnostic specificity as a potential complementary diagnostic tool to overcome limitations of current anal cancer screening strategies.
Background: While the microbiota has been associated with human papillomavirus malignant transformation, it is unclear whether anal bacteria could improve the low specificity of anal cytology for the screening of high-grade intraepithelial squamous neoplasia (HSIL) Methods: We recruited men who have sex with men undergoing anal cytology and high-resolution anoscopy. We assessed the microbiota composition from fecal samples and cytobrush anal samples using 16S ribosomal DNA sequencing in participants with or without biopsy-proven HSIL, (bHSIL). We selected bacterial biomarkers based on their linear discriminant analysis. We assessed their predictive performance using logistic regression and bootstrap resampling. Results: We included 128 individuals, 47 (36.7%) with bHSIL and 99 (77.3%) with human immunodeficiency virus. We detected 40 potential predictors of bHSIL. Ruminococcaceae NK4A214 group, Alloprevotella genus, Prevotella melanonigenica, and Ruminococcaceae UCG-014 were the most predictive of bHSIL. From 35 false-positive cytologic results, the combination of these 4 biomarkers with the anal cytology reclassified to true-negative 33 individuals (94%) and showed good diagnostic performance (area under the receiver operating characteristic curve, 0.805; 95% confidence interval, .728-.882). Conclusions: We found anal-associated bacteria indicative of a higher risk of precancerous anal lesions, which combination was highly specific. The microbiota could be developed as a complementary diagnostic tool to overcome the limitations of the current screening strategy for anal cancer.
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