The latest research results of the team led byFang Jingyuan from the affiliated Renji Hospital are published in the leading journalof life science Cel

Professor Fang Jingyuan and his team, from Shanghai Jiao Tong University School of Medicine affiliated Renji Hospital and Shanghai Institute of Digestive Disease and State Key Laboratory for oncogenes and Related genes, through analyzing mucosal DNA sequence from both the patients with and without Colorectal Cancer(CRC) recurrence,found that Fusobacteria(F.) nucleatum were abundant in patients with tumor recurrence, and identified the mechanism that the bacteria would induce cancer cell autophagy and then cause drug resistance in chemotherapy and postoperative recurrence of the tumor, which decreased 5 year survival rate in the patients with CRC. The latest research is published in the July 27 issue of the journal Cell, a leading journal of life science. The studyprovides a solid foundation for bothpredicting colorectal cancer prognosis through analyzing intestinal flora (i.e. the highF. nucleatum in surgical specimens usually indicatesthe high chance of a recurrence) and early warning forCRC chemotherapy (the high levels of the bacteria is often a sign of poor efficacy with common-used chemotherapy drugs such as 5 - FU and oxaliplatin).

Colorectal cancer(CRC), one of the most common malignant tumor in our country, whose incidence accounted for 24.3% and mortality 22.9% globally in China in 2015, has an increasing incidence and mortality in recent years in China. Although great progress has been made in the diagnosis and treatment of CRC in recent years, recurrence in CRC patients after chemotherapy (including 5 - FU and oxaliplatin into) remains difficult in clinical trials, which significantly affects the prognosis in patients. Through studying hundreds of cases in three postoperative chemotherapy CRC clinical cohort in recent five years, Fang Jingyuan havefound and confirmed that the high abundance of intestinal flora in CRC patients is probably the most important reason for chemoresistancesuch as 5 - FU and oxaliplatin and for the failure chemotherapy in CRC patients. Compared with the traditional methods (including the international authority of the American Joint Committee on Cancer Staging and malignant tumor cell differentiation degree), high abundance of the F. nucleatumis much more valuable in predicting the prognosis in CRC patients. Further experimental results showed that the bacterium could lead to CRC chemoresistance through various complex mechanisms.

This study was the first to find the regulation of F.nucleatum in CRC chemoresistance, and to explain its corresponding mechanism in detail. This thesis not only put forward the possible markers for predicting prognosis and early warning of risk of chemoresistance by detecting mucosal F.nucleatum abundance, but also would providethe potential strategies for the development of new drugs, which not only satisfied the precise medicine, but also was expected to improve the therapeutic effect of CRC patients to improve the quality of life and prolong the effective lifetime.

Professor Fang Jingyuanis the corresponding author,Researchers HongJie, Chen Haoyan, Chen Yingxuan together with Professor Zou Weiping from the University of Michigan are corresponding authors, and two doctorial students of Professor Fang Jingyuan are the first authors. All the research was done by Renji Hospital, and Professor Zou provided important guidance and assistance in the design and implementation of the study.

In recent years, the Digestive Department of Renji Hospital has been committed to the CRC mechanism and its clinical diagnosis and treatment, and has received remarkable achievements. According to Professor Fang Jingyuan, their results may provide a new exploration in reversingchemoresistance and improving postoperative outcomes in patients with colorectal cancer by eliminating or reducing F.nucleatum.

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