Analysis of the changes in the microbiome of multiple sites before and after radiotherapy for cervical cancer and its correlation with the therapeutic effect of radiotherapy
宫颈癌放疗前后多部位微生物组的变化及与放疗疗效的相关性分析

摘要

目的 解析宫颈癌患者放疗前后多部位微生物组动态变化及其与疗效的关联。方法 于2024年1月至2024年7月纳入36例初治患者，分别在放疗前（T0）及放疗结束（T1）采集肿瘤组织、阴道、尿道、粪便及口腔唾液样本，行16S rRNA V3–V4区测序；依据RECIST 1.1标准评估疗效，结合α/β多样性与Spearman分析挖掘菌群特征与客观缓解率（ORR）的关系。结果 放疗显著改变肿瘤内与口腔菌群结构，其中肿瘤内Proteobacteria升高、Bacteroidetes降低，口腔Epsilonbacteraeota升高，三者变化幅度均与ORR呈正相关（P＜0.05）。结论 肿瘤微环境与口腔菌群响应具有部位特异性，可作为放疗疗效预测的潜在生物标志物。

Abstract

Objective To analyze the dynamic changes of the microbiome in multiple sites before and after radiotherapy in patients with cervical cancer and their association with therapeutic effects.
Methods From January 2024 to July 2024, 36 newly diagnosed patients were included. Tumor tissue, vaginal, urethral, fecal and oral saliva samples were collected before radiotherapy (T0) and at the end of radiotherapy (T1) respectively, and 16S rRNA V3-V4 region sequencing was performed. The therapeutic effect was evaluated according to the RECIST 1.1 standard, and the relationship between microbiota characteristics and objective response rate (ORR) was explored by combining α/β diversity and Spearman analysis.
Results Radiotherapy significantly altered the structure of the microbiota within the tumor and in the oral cavity. Among them, Proteobacteria in the tumor increased, Bacteroidetes decreased, and Epsilonbacteraeota in the oral cavity increased. The amplitudes of all three changes were positively correlated with ORR (P<0.05).
Conclusion   The response of the tumor microenvironment and oral microbiota is site-specific, which could be used as a potential biomarker for predicting the efficacy of radiotherapy.