Intestinal Microbiota as Biomarkers for Different Colorectal Lesions Based on Colorectal Cancer Screening Participants in Community

Gairui Li ^1,2 Dan Zhao ² Binfa Ouyang ² Yinggang Chen ^3* Yashuang Zhao ^1*

• ¹ Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China
• ² Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
• ³ National Cancer Center, Cancer Hospital Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China

The dysregulation of intestinal microbiota has been implicated in the pathogenesis of colorectal cancer (CRC). However, the utilization of intestinal microbiota for identify the lesions in different procedures in CRC screening populations remains limited. In this study, 16S rRNA gene sequencing was used to profile the intestinal microbiota communities. A total of 529 high-risk individuals who underwent CRC screening were included, comprising 13 advanced adenomas (Aade), 5 CRC, 59 non-advanced adenomas (Nade), 129 colon polyps (Pol), 99 cases of colorectal inflammatory disease (Inf), and 224 normal controls (Nor). Our findings revealed that the Nor group exhibited significantly higher Gut Microbiota Health Index (GMHIs) and the lowest average variation degree (AVD) compared to the four Lesion groups. The model incorporating 10 bacterial genera demonstrated optimal efficacy in distinguishing CRC and Aade from Nor, with an area under the curve (AUC) of 0.81 and a 95% confidence interval (CI) of 0.72 to 0.89. Specifically, the 55 bacterial genera combination model exhibited superior performance in differentiating CRC from Nor (AUC 0.98; 95% CI, 0.96-1). the 25 bacterial genera combination showed superior performance in distinguishing Aade from Nor (AUC 0.95). Additionally, the 27 bacterial genera combination demonstrated superior efficacy in differentiating Nade from Nor (AUC 0.82). The 13 bacterial genera combination exhibited optimal performance in distinguishing Inf from Nor (AUC 0.71). Our study has identified specific microbial biomarkers that can differentiate between colorectal lesions and healthy individuals. The intestinal microbiota markers identified may serve as valuable tools in community-based CRC screening programs.