J Cancer 2021; 12(6):1583-1591. doi:10.7150/jca.50111

Research Paper

Clinicopathological and prognostic significance of Fusobacterium nucleatum infection in colorectal cancer: a meta-analysis

Shu-chen Huangfu*, Wen-bin Zhang*, Hao-ran Zhang, Yang Li, Yi-ran Zhang, Jin-lin Nie, Xiao-dong Chu, Chang-shun Chen, Hai-ping Jiang, Jing-hua Pan

Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou 510632, China.
*These authors contributed equally to this work.

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Citation:
Huangfu Sc, Zhang Wb, Zhang Hr, Li Y, Zhang Yr, Nie Jl, Chu Xd, Chen Cs, Jiang Hp, Pan Jh. Clinicopathological and prognostic significance of Fusobacterium nucleatum infection in colorectal cancer: a meta-analysis. J Cancer 2021; 12(6):1583-1591. doi:10.7150/jca.50111. Available from https://www.jcancer.org/v12p1583.htm

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Abstract

Background: This study aimed to clarify the relationship between F. nucleatum levels and the prognosis of CRC, which is still controversial.

Methods: Relevant articles were searched on PubMed, Web of Science, PMC and Embase up to April 7, 2020. Outcomes of interest included clinical characteristics, molecular characteristic and survival analysis. HR (OR), odds ratios (OR) and 95% confidence interval (CI) were calculated to explore the prognostic value and relationship of clinical characteristics of Fusobacterium nucleatum in CRC.

Results: A total of 3626 CRC patients from 13 eligible studies were included. High levels of F. nucleatum were associated with worse prognosis, as such parameters as overall survival (OS) (hazard ratio [HR] = 1.40, 95% confidence interval [CI]: 1.40 - 1.63, P < 0.0001), disease-free survival (DFS) (HR = 1.71, 95% CI: 1.29-2.26, P = 0.0002), and cancer-specific survival (OR= 1.93, 95% CI: 1.42-2.62, P <0.0001). F. nucleatum levels were related with T3-T4 stage (OR = 2.20, 95% CI: 1.66-2.91, P < 0.00001), M1 stage (OR = 2.11, 95% CI: 1.25-3.56, P = 0.005), poor tumor differentiation (OR = 1.83, 95% CI: 1.11-3.03, P =0.02), microsatellite instability-high (OR = 2.53, 95% CI: 1.53-4.20, P = 0.0003), and KRAS mutation (OR =1.27, 95% CI: 1.00-1.61, P=0.05) showed.

Conclusions: High levels of F. nucleatum suggest a poor prognosis and are associated with tumor growth, distant metastasis, poor differentiation, MSI-high, and KRAS mutation in CRC patients.