Colorectal cancer and gut microbiota studies in China

Figures & data

Table 1. Characteristics of the intestinal bacterial microbiota of CRC in recent Chinese studies.

Authors	Population	Sample collection	Microbial diversity	Significant enrichment	Significant losses
Dai et al.^Citation5	CRC vs. controls	Feces	Decrease in the Hong Kong cohort	Bacteroides fragilis, Fusobacterium nucleatum, Porphyromonas asaccharolytica, Parvimonas micra, Prevotella intermedia, and Alistipes finegoldii
Xie et al.^Citation10	CRC vs. controls	Feces		Clostridium symbiosum and F. nucleatum
Zhang et al.^Citation11	CRC vs. controls	Feces	No statistical differences	Peptostreptococcus stomatis, P. micra, Gemella morbillorum, P. asaccharolytica, S. moorei, F. nucleatum, Ruminococcus torques, Campylobacter rectus, Clostridium scindens, and Caproicibacterium lactatifermentans	Eubacterium eligens, Eubacterium hadrum, Eubacterium hallII, Eubacterium desmolans, Blautia faecis, Roseburia faecis, Ruminococcus lactaris, and Streptococcus salivarius
Yu et al.^Citation12	CRC vs. controls	Feces	Decrease	P. micra, Solobacterium moorei, and F. nucleatum
Li et al.^Citation13	CRC vs. HC	Feces		B. fragilis	Faecalibacterium prausnitzii, Bifidobacterium adolescent, Clostridium clostridioforme, Blautia producta and R. faecis
Chen et al.^Citation14	CRC vs. HC	Feces		The number of viable colonies of Escherichia coli and Enterococcus faecalis	The number of living colonies of Campylobacter, Bifidobacterium, and Lactobacillus
Yuan et al.^Citation15	CRC vs. HC	Feces	Decrease	Bifidobacterium, Bacteroides, and Megasphaera	Collinsella and Faecalibacterium
Chang et al.^Citation16	CRC vs. HC	Feces	No statistical differences	G. morbillorum and Shigella sonnei	Streptococcus gallolyticus
Du et al.^Citation17	CRC vs. HC	Feces	Decrease	Bacteroidota, Fusobacteriota, and Campylobacter	Firmicutes
Coker et al.^Citation18	CRC vs. HC	Feces		P. stomatis, F. nucleatum, P. micra, Peptostreptococcus anaerobius, and B. fragilis	Eubacterium ventriosum, Roseburia interinalis and Roseburia inulivorans
Yeoh et al.^Citation19	CRC vs. non-CRC	Feces		Fusobacterium gonidiaformans and F. nucleatum
Yang et al.^Citation20	CRC vs. healthy family members	Feces		Roseburia inulinivorans, Clostridium ramosum, Porphyromonas gingivalis, F. nucleatum, and G. morbillorum
Li et al.^Citation21	CRC	Tumor mucosa vs normal mucosa	No statistical differences	Fusobacterium, Gemella, Campylobacter, and Streptococcus	Rhodococcus, Blautia, and Dorea
Liu et al.^Citation7	CRC	Tumor tissues vs. adjacent normal tissues	No statistical differences	Peptostreptococcus and Fusobacterium
	CRC vs. CRA	Tumor tissues	Decrease	Fusobacterium, Bacteroides, Parvimonas, and Prevotella
Feng et al.^Citation8	CRC vs. advanced CRA or HC	Feces	No statistical differences	A. putredinis, Lachnospiraceae bacterium and E. coli	Streptococcus thermophilus
Hua et al.^Citation22	CRC vs. CRA vs. HC	Feces	No statistical differences		Acidaminococcus exhibited a decreased relative abundance from HC to CRA and CRC
Gao et al.^Citation23	CRC vs. CRA vs. HC	Feces			Firmicutes exhibited a decreased relative abundance from HC to CRA and CRC
Wu et al.^Citation24	CRC vs. CRA	Feces	No statistical differences	F. nucleatum, P. asaccharolytica, P. stomatis, P. micra, and Escherichia-Shigella sp.	Blautia obeum, Butyricicoccus faecihominis, and Dorea longicatena
Jin et al.^Citation25	CRC vs. CRC postoperative	Feces	No statistical differences	Gemella, Howardella, and Parascardovia	Tyzzerella 3 and Lawsonella
Huang et al.^Citation26	CRC vs. HC	Feces	Increase	Negativicutes and Clostridia	Clostridia and Negativicutes
	CRC cases after chemotherapy vs. CRC		No statistical differences	Verrucomicrobia and Akkermansiaceae
Huo et al.^Citation27	CRC recurrence vs. non-CRC recurrence	Tumor tissues	No statistical differences	Firmicutes, Bacteroidetes, and Fusobacteria
		Off-tumor tissues			Firmicutes and Bacteroidetes
Nakatsu et al.^Citation28	early-stage CRC vs. late-stage CRC	Lesion-adjacent mucosae	No statistical differences	Fusobacterium, Parvimonas, Gemella, and Leptotrichia	Bacteroides, Blautia, Faecalibacterium prausnitzii, Collinsella aerofaciens and Alistipes putredinis
Xu et al.^Citation29	young-onset CRC vs. old-onset CRC	Tumor tissues	Decrease	Schaalia cardiffensis, Diaphorobacter, Actinomyces, Actinomycetaceae, and Actinomycetales	Acidobacteriota and Pyramidobacter piscolens
Yang et al.^Citation30	young-onset CRC vs. old-onset CRC	Feces	Increase	Fusobacterium, Flavonifractor, and Odoribacter	Streptococcus, Fusobacterium, and Gemella
Zhong et al.^Citation31	Left-sided colon cancer vs. right-sided colon cancer	Tumor tissue and feces	Increase	Clostridium perfringens, Bacteroides coprocola DSM 17,136, Collinsella aerofaciens, and S. gallolyticus subsp. Macedonicus in patients from Harbin	Bifidobacterium dentium and Ruminococcus sp. 15975 in patients from Harbin
				Bacteroides vulgatus in patients from Xiamen	B. fragilis and S. gallolyticus subsp. Macedonicus in patients from Xiamen

CRC: colorectal cancer; CRA: colorectal adenoma; HC: healthy controls.

Figure 1. Schematic representation of gut microbiota and their metabolites involved in colorectal carcinogenesis at the cellular and molecular levels. Gut bacteria such as Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, Peptostreptococcus anaerobius, pks⁺ Escherichia coli, and Parvimonas micra, and their virulence factors FadA, B. fragilis toxin, and colibactin contribute to the colorectal cancer (CRC) development by activating different pathways that trigger DNA damage, intestinal inflammation, macrophage polarization, and apoptosis.

Table 2. Gut microbiota-related biomarkers for the screening and early diagnosis of CRC in recent Chinese studies.

Authors	Cohort	Gut microbiota-related biomarkers	AUC
Bacterial-related biomarkers
Gao et al.^Citation23	CRC vs. CRA	the combined panel of 12 species (Parvimonas unclassified, Fusobacterium nucleatum, Roseburia intestinalis, Gardnerella vaginalis, Peptostreptococcus anaerobius, Peptostreptococcus stomatis, Lactobacillus iners, Gemella morbillorum, Porphyromonas asaccharolytica, Faecalibacterium prausnitzii, Atopobium vaginae, and Parvimonas micra) and three metabolites	0.994
Coker et al.^Citation18	CRC vs. NC	11 metabolite biomarkers and six bacterial species (F. nucleatum, P. anaerobius, P. micra, Roseburia inulinivorans, Eikenella corrodens, and Xanthomonas perforans)	0.9417
Yang et al.^Citation20	CRC vs. NC	gene 8,122,329 (unknown function from Coprobacillus)	0.930
Chen et al.^Citation85	CRC vs. CRA	Eight gut microbiome-associated serum metabolites	0.92
Wu et al.^Citation24	CRC vs. CRA	24 differential biomarkers (Streptococcus thermophilus TH1435, P. micra, Bacteroides dorei, Clostridium scindens, Erysipelatoclostridium ramosum, Blautia sp., Eubacterium coprostanoligenes group sp., Lachnospira pectinoschiza, Ruminococcaceae UCG-002 sp., Ruminococcus bromii, Porphyromonas sp. HMSC077F02, Porphyromonas sp. 2007b, Eubacterium ruminantium, Tyzzerella 3 sp., Hungatella hathewayi WAL-18680, Blautia faecis, Bacteroides nordii, Lachnospiraceae UCG-010 sp., Eubacterium ventriosum group sp., Streptococcus infantarius, R. intestinalis, Merdibacter massiliensis, Ruminococcus gnavus group sp., Roseburia hominis A2–183) with age and body mass index	0.89
Xie et al.^Citation10	CRC vs. NC	Combination of Clostridium symbiosum and F. nucleatum abundance with FIT and CEA test	0.876
Hua et al.^Citation22	CRC vs. CRA	Combination of the top ten species (Butyricimonas synergistica, Agrobacterium larrymoorei, Bacteroides plebeius, Lachnospiraceae bacterium feline oral taxon 001, C. scindens, Prevotella heparinolytica, bacterium LD2013, Streptococcus mutans, L. bacterium 19gly4, and Eubacterium hallii)	0.8554
Yu et al.^Citation12	CRC vs. NC	Two gene biomarkers (from F. nucleatum and P. micra)	0.84
Dai et al.^Citation5	CRC vs. NC	7 CRC-enriched bacterial biomarkers (B. fragilis, F. nucleatum, P. asaccharolytica, P. micra, Prevotella intermedia, Alistipes finegoldii, and Thermanaerovibrio acidaminovorans)	0.80
Liang et al.^Citation86	CRC vs. NC	A simple linear combination of four bacteria (F. nucleatum + Clostridium hathewayi + undefined species (labeled as m7) - Bacteroides clarus)	0.886
Fungal-related biomarkers
Coker et al.^Citation36	CRC vs. NC	Fourteen fungal biomarkers (Aspergillus flavus, Kwoniella mangrovensis, Pseudogymnoascus sp. VKM F-4518, Debaryomyces fabryi, Aspergillus sydowii, Moniliophthora perniciosa, Kwoniella heavenensis, Aspergillus ochraceoroseus, Talaromyces islandicus, Malassezia globosa, Pseudogymnoascus sp. VKM F-4520, Aspergillus rambelli, Pneumocystis murina, and Nosemia apis)	0.93
Gao et al.^Citation37	CRC vs. NC	Thirteen fungal biomarkers (Phanerochaete chrysosporium, A. flavus, Entomophthora muscae, A. rambelli, fungal sp ARF18, Metschnikowia cubensis, Fusarium pininemorale, Spraguea lophii, Candida versatilis, Lachancea waltii, Taxomyces andreanae, Exophiala mesophila, and Brettanomyces anomalus)	0.757
Viral-related biomarkers
Nakatsu et al.^Citation41	CRC vs. NC	Twenty-two viral biomarkers (Orthobunyavirus, Inovirus, Tunalikevirus, L5likevirus, Phikzlikevirus, Betabaculovirus, Sp6likevirus, Sfi21dtunalikevirus, Punalikevirus, Lambdalikevirus, C2likevirus, Mulikevirus, Twortlikevirus, γ-Sphaerolipovirus, Circovirus, Spounalikevirus, Cytomegalovirus, Epsilon15likevirus, N15likevirus, Phikmvlikevirus, Cyprinivirus, and Lymphocryptovirus)	0.802
Multi-kingdom biomarkers
Lin et al.^Citation35	CRC vs. NC	Five fungi (Aspergillus kawachii, Rhizophagus clarus, Baudoinia panamericana, A. rambelli, Trichoderma atroviride) and nine bacteria (P. micra, F. nucfeatum, G. morbillorum, Porphyromonas asaccharolytica, Dialister pneumosintes, Anaerostipes hadrus, Romboutsia ilealis, Brachyspira pilosicoli, and Streptococcus safivarius)	0.9002
Liu et al.^Citation9	CRC vs. NC	11 bacterial (F. nucleatum, P. micra, G. morbillorum, Ruminococcus bicirculans, R. intestinalis, Pseudobutyrivibrio xylanivorans, Streptococcus anginosus, and Eubacterium eligens), four fungal (A. rambelli, Sistotremastrum suecicum, T. islandicus, and Aspergillus niger) and one archaeal (Pyrobaculum arsenaticum) biomarkers	0.83

AUC: area under the receiver-operating characteristics curve; CRC: colorectal cancer; CRA: colorectal adenoma; NC: normal controls; rpoB: RNA polymerase subunit β; FIT: fecal immunochemical test; CEA: carcinoembryonic antigen.

Figure 2. Overview of candidates for gut microbiota modulation for the prevention and treatment of colorectal cancer, including diet modulations, microecological agents, fecal microbiota transplantation, antibiotics, and traditional Chinese medicine.

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