Lung Microbiome In Advanced Non Small Cell Lung Cancer And Its Relationship With Prognosis

Background and PurposeLung microbiome in lung cancer patients was under a intense study.Previous study had confirmed the respiratory microbiome in lung cancer patients was different with healthy controls.And lung microbiome was distinguished with various pathology and clinical stage.Most lung cancer patients was in advanced stage when diagnosed.Thus the prognosis was obviously more important.And the relationship between lung microbiome and prognosis was still unclear.In this study,we collected the bronchial washing of non-small cell lung cancer patients diagnosed by bronchoscopy biopsy in the Department of Respiratory and Critical Care Medicine of Nanfang Hospital,and investigated the airway microbiome and its correlation with prognosis for the better understanding of the biological characteristics of lung cancer and provide new viewpoint for future clinical diagnosis and treatment.Subjects and Methods(1)We gathered the complete electronic medical records of 32 inpatients who received the diagnosis of non-small cell lung cancer by bronchoscopy biopsy in the Department of Respiratory and Critical Care Medicine of Nanfang Hospital from October 31,2016 to October 31,2017.All patients were enrolled with a follow-up study,recorded their survivals,the following therapy and the situations of the radiographic studies.Patients were divided into two groups:the alive group(group FY)and the dead group(group FN)according to their follow-up situations.Thereafter,patients who were dead within one year were assessed the group FNi,another patients who had died were identified as group FN2.And we characterized and compared the lung microbiome between groups.(2)According to the antibiotics usage,we divided the dead patients into two different groups:with antibiotics group(Fai)and without antibiotics group(FA2).And we characterized and compared the lung microbiome between groups.Results(1)32 patients who were diagnosed as non-small cell lung cancer were enrolled on our study.23 patients had died(group Fn)and 9 patients were survivors(group Fy)until December 31,2018.16 patients were dies within 1 year,(group FNi)and other 7 patients were died in 1 year later(group FN2).There were no difference between both a and β diversity of Fy and FN group.In phylum level,the Proteobacteria was most predominant in both two groups.The most common genus of Fy group was Veillonella,however the most abundant bacteria of FN group was Streptococcus in genus level.(2)In phylum level,the most relatively abundant phylum was Firmicutes in group FN1,the top phylum of group FN2 was Proteobacteria.The most abundant genus was Streptococcus in both two groups.The relative abundance of Proteobacteria in group Fy was higher than group FN1 and the abundance of Actinobacteria in group FY was more than group FN2·In genus level,the relative abundance of Acinetobacter in group FY was higher than group FN2.However,the relative abundance of Halomonas and Pseudomonas in group FN1 were lower than group FN2.(3)The beta diversity of patients who had died with antibiotic treatment(Fai)was different from dead patients without antibiotic therapy(FA2).And the relative abundance of Proteobacteria and Bacteroidetes in group FA1 were higher than group FA2.ConclusionOur study indicated the lung microbiome were variable in different prognosis of non small cell lung cancer patients.The beta diversity between group FN1,and FN2 were distinguished.It is noteworthy that we investigated the lower relative abundance of specific genus was significant correlated with the 1 year mortality.The antibiotic treatment led to the dynamic change of the lung microbiome community of the dead patients.