Gastroenterology Shanghai Jiaotong University Fang Jingyuan/Chen Yingxuan/Wang Zheng found that these two kinds of bacteria in feces can assist in early diagnosis/screening of gastric cancer

The majority of iNature gastric cancer (GCa) patients are diagnosed at an advanced stage
.

This study aimed to understand novel fecal characteristics for clinical application in early diagnosis of GCa
.

On February 12, 2022, Fang Jingyuan, Chen Yingxuan and Wang Zheng of Shanghai Jiaotong University published a joint communication online in Gastroenterology (IF=23) entitled "Fecal signatures of Streptococcus anginosus and Streptococcus constellatus for non-invasive screening and early warning of gastric cancer”, an observational study including 1,043 patients from ten hospitals in China
.

In the discovery cohort, 16S rRNA gene analysis was performed on paired samples (tissue, stool) from patients with GCa and chronic gastritis (ChG) to identify differentially enriched microbes
.

Streptococcus anginosus (Sa) and Streptococcus constellatus (Streptococcus constellatus, Sc) were significantly enriched
.

Compared with late GCa, both the signature parallel test Sa ∪Sc or single signature Sa/Sc showed superior sensitivity in detecting early GCa (Sa: 75.
6% vs.
72.
1%, P<0.
05; Sc: 84.
4% vs.
64.
0%, P<0.
001; Sa∪Sc: 91.
1% vs.
81.
4%, P<0.
01) and specificity (Sa: 84.
0% vs.
83.
9%; Sc: 70.
4% vs.
82.
3%; Sa∪Sc: 64.
0% vs.
.
73.
4%)
.

The stool signature Sa∪Sc was superior to Sa∪CEA/Sc∪CEA in identifying advanced GCa (sensitivity: 81.
4% vs.
74.
2%; 81.
4% vs.
72.
3%, P<0.
01; specificity: 73.
4% vs.
81.
0 % ; 73.
4% and 81.
0%)
.

The performance of Sa∪Sc in early and late GCa diagnosis was validated in a validation cohort
.

In conclusion, this study found that fecal Sa and Sc are non-invasive, accurate and sensitive features for early warning of GCa
.

Gastric cancer (GCa) is one of the five most common and deadly malignancies worldwide
.

Almost half of the estimated global deaths from GCa occur in China
.

Early screening is crucial for the prevention and treatment of GCa, as most patients are diagnosed at an advanced stage with a relatively poor prognosis
.

However, endoscopy is not a universally applicable invasive screening test for GCa
.

Currently, neither non-invasive nor sensitive features are available and are widely used for the screening and early diagnosis of GCa, which is a great challenge in GCa-related research
.

According to Correa's model, Helicobacter pylori is one of the major risk factors for gastric cancer, and eradication of Helicobacter pylori can partially prevent it
.

However, only 2-3% of H.
pylori-infected individuals eventually develop GCa, suggesting that other factors, including unknown organisms, may be involved in gastric carcinogenesis
.

Therefore, other specific bacteria associated with GCa must be identified to establish surveillance strategies based on carcinogenic risk stratification
.

However, knowledge about non-H.
pylori is extremely limited
.

Therefore, their role in gastric cancer remains largely undetermined
.

Several studies have shown that the bacterial composition of the stomach differs significantly between patients with GCa and those with chronic gastritis (ChG)
.

Preliminary identification of a microbiome network with excellent ability to discriminate between GCa and ChG resulted in a method for detecting diverse microbial combinations by invasive mucosal biopsy in the diagnosis of GCa
.

Against this background, there appears to be an urgent need to identify new diagnostic features and therapeutic targets for GCa
.

Schematic diagram of the article (pictured from Gastroenterology) Enrichment of Streptococcus anginosus (Sa) was observed in tumor tissue of GCa patients
.

Nonetheless, its potential utility as a bacterial signature to detect GCa remains undetermined
.

In the present study, it was reported that two species, Streptococcus anginosus (Sa) and Streptococcus constellatus (Sc), were enriched in the feces of precancerous, early and advanced GCa patients
.

This study aimed to explore a non-invasive and sensitive screening method for early warning of GCa using fecal bacterial signatures and to evaluate its performance as an early GCa screening or diagnostic tool
.

This study found that Streptococcus anginosus (Sa) and Streptococcus staphylococcus ( Streptococcus constellatus, Sc) was significantly enriched
.

Compared with late GCa, both the signature parallel test Sa ∪Sc or single signature Sa/Sc showed superior sensitivity in detecting early GCa (Sa: 75.
6% vs.
72.
1%, P<0.
05; Sc: 84.
4% vs.
64.
0%, P<0.
001; Sa∪Sc: 91.
1% vs.
81.
4%, P<0.
01) and specificity (Sa: 84.
0% vs.
83.
9%; Sc: 70.
4% vs.
82.
3%; Sa∪Sc: 64.
0% vs.
.
73.
4%)
.

Fecal characteristics Sa ∪Sc was superior to Sa ∪CEA/Sc ∪CEA in identifying advanced GCa (sensitivity: 81.
4% vs.
74.
2%; 81.
4% vs.
72.
3%, P<0.
01; specificity: 73.
4% vs.
81.
0 % ; 73.
4% and 81.
0%)
.

 The performance of Sa∪Sc in early and late GCa diagnosis was validated in a validation cohort
.

In conclusion, this study found that fecal Sa and Sc are non-invasive, accurate and sensitive features for early warning of GCa
.

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