Exploiting the Microbiota for the Diagnosis of Anal Precancerous Lesions in Men Who Have Sex With Men
Por:
Ron R, Cabello A, Gosalbes MJ, Sánchez-Conde M, Talavera-Rodríguez A, Zamora J, Monge-Maillo B, Jiménez D, Martínez-Sanz J, López Y, Crespillo C, Velasco T, Moreno S, Pérez-Molina JA and Serrano-Villar S
Publicada:
1 oct 2021
Ahead of Print:
1 feb 2021
Resumen:
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.
Filiaciones:
Ron R:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Cabello A:
Division of Infectious Diseases, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
:
Area of Genomics and Health, FISABIO-Salud Pública, Valencia, Spain and CIBERESP, Madrid, Spain
Sánchez-Conde M:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Talavera-Rodríguez A:
Bioinformatics Unit, Hospital Universitario Ramon y Cajal, IRYCIS, Madrid, Spain
Zamora J:
Clinical Biostatistics Unit, Hospital Universitario Ramon y Cajal, IRYCIS, and CIBERESP, Madrid, Spain
Monge-Maillo B:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Jiménez D:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Martínez-Sanz J:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
López Y:
Area of Genomics and Health, FISABIO-Salud Pública, Valencia, Spain and CIBERESP, Madrid, Spain
Crespillo C:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Velasco T:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Moreno S:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Pérez-Molina JA:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
Serrano-Villar S:
Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain
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