MICRObiota on BILIOpancreatic malignant diseases [MICROBILIO]: A systematic review

Abstract

Introduction:

The increase in the incidence of pancreatic and biliary cancers has attracted the search for methods of early detection of diseases and biomarkers. The authors propose to analyze new findings on the association between microbiota and Pancreatic Ductal Adenocarcinoma (PDAC) or Cholangiocarcinoma (CCA).

Methods:

This systematic review was carried out according to the items of Preferred Reports for Systematic Reviews and Protocol Meta-Analysis (PRISMA-P). This study was registered by the Prospective Register of Systematic Reviews (PROSPERO), identification code CRD42020192748 before the review was carried out. Articles were selected from the PUBMED, EMBASE, and Cochrane databases.

Results:

Most studies (86.67%) used 16s rRNA as a sequencing method. The main comorbidities found were diabetes mellitus, systemic arterial hypertension, and dyslipidemia. Many studies were limited by the small number of participants, but the biases were mostly low. There was very little concordance about the composition of the microbiome of different sites, for both case and control groups when compared to other studies’ results. Bile sample analysis was the one with a greater agreement between studies, as three out of four studies found Escherichia in cases of CCA.

Conclusion:

There was great disagreement in the characterization of both the microbiota of cases and control groups. Studies are still scarce, making it difficult to adequately assess the data in this regard. It was not possible to specify any marker or to associate any genus of microbiota bacteria with PDAC or CCA.

Keywords:
Pancreatic Neoplasms; Microbiota; Early detection of cancer; Dysbiosis; Tumor microenvironment; Biliary tract neoplasms; Gastrointestinal microbiome

HIGHLIGHTS

Microbial agents and their metabolites are being tested to develop treatments that can reduce the tumor and are potentially preventable.

Microbiota is observed in all clinical and pathological stages of carcinogenesis, from its development, diagnosis, and treatment, including prognosis and survival.

There is a lack of studies on biliary microbiota and its relationship with hepatobiliopancreatic diseases.