From adenoma to CRC stages: the oral-gut microbiome axis as a source of potential microbial and metabolic biomarkers of malignancy

Sep 24, 2026

Uploaded by Liam

Background: Approximately 95% of colorectal cancers (CRC) consist of adenocarcinomas arising from colonic adenomatous polyps (AP). The gut microbiota is implicated in CRC occurrence and progression, and the study aims to characterize microbial spatial variations across AP and CRC stages, using an integrated multi-niche framework. Methods: Saliva, tissue, and stool samples from 61 surgery patients were analyzed using microbiota profiling and NMR-based fecal metabolomics with multivariate and univariate statistics. Results: CRC shows distinct tissue and fecal microbial patterns, including Fusobacterium shifts, correlated microbial taxa, and increased lactate with CRC fecal profiles. Conclusion: Microbiota communities and oncometabolites may support CRC development and enable improved diagnostic tools.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Study background and rationale

Methods

Observational study design and sample collection

Microbiota profiling and NMR metabolomics

Results

Microbial differences between CRC and AP

Associations across tissues and fecal taxa

Fecal metabolite changes by NMR

Conclusion

Implications for CRC diagnostic tools and further research

Neoplasia 40 (2023) 100901 Contents lists available at ScienceDirect Neoplasia journal [homepage:](homepage: www.elsevier.com/locate/neo)[ www.elsevier.com/locate/neo](homepage: www.elsevier.com/locate/neo) | From adenoma to CRC stages: the oral-gut microbiome axis as a source of potential microbial and metabolic biomarkers of malignancy
Edda Russo a, Leandro Di Gloria b, Giulia Nannini a, Gaia Meonic,d, Elena Niccolai a,
Maria Novella Ringressia, Simone Baldia, Renato Fanie, Leonardo Tenoric,d, Antonio Taddei a, Matteo Ramazzottib,∗∗, Amedeo Amedei a,f,∗
a Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
b Department of Biomedical, Experimental and Clinical Sciences "Mario Serio" University of Florence, Florence, Italy c Magnetic Resonance Center (CERM) and Department of Chemistry “Ugo Schiﬀ,” University of Florence, Sesto Fiorentino, Italy d Consorzio Interuniversitario Risonanze Magnetiche Metallo Proteine (CIRMMP), Sesto Fiorentino, Italy
e Department of Biology, University of Florence, Via Madonna del Piano 6, Sesto Fiorentino, 50019 Florence, Italy f Interdisciplinary Internal Medicine Unit, Careggi University Hospital, 50134 Florence, Italy. | | | | | --- | --- | --- | --- | | a r t i c l e i n f o | | a b s t r a c t | | | Keywords: Microbiota colorectal cancer
colonic adenomatous polyps
microbiota metabolomics biomarkers cancer staging | | Background: Approximately 95% of Colorectal cancers (CRC) consist ofadenocarcinomas originating from colonic Adenomatous polyps (AP). Increasing importance in CRC occurrence and progression has been attributed to the gut microbiota; however, a huge proportion of microorganisms inhabit the human digestive system. So, to comprehensively study the microbial spatial variations and their role in CRC progression, from AP to the diﬀerent CRC phases, a holistic vision is imperative, including the simultaneous evaluation of multiple niches from the gastrointestinal system. Through an integrated approach, we identiﬁed potential microbial and metabolic biomarkers, able to discriminate human CRC from AP and/or also the diﬀerent Tumor node metastasis (TNM) staging. In addition, as the microbiota contributes to the production of essential metabolic products detectable in fecal samples, we analysed and compared metabolites obtained from CRC and AP patients by using a Nuclear magnetic resonance (NMR) approach.
Methods: In this observational study, saliva, tissue and stool samples from 61 patients, have been collected, including 46 CRC and 15 AP patients, age and sex-matched, undergoing surgery in 2018 at the Careggi University Hospital (Florence, Italy). First, the microbiota in the three-district between CRC and AP patients has been characterized, as well as in diﬀerent CRC TNM stages. Subsequently, proton NMR spectroscopy has been used in combination with multivariate and univariate statistical approaches, to deﬁne the fecal metabolic proﬁle of a restricted group of CRC and AP patients.
Results: CRC patients display a diﬀerent proﬁle of tissue and fecal microbiota with respect to AP patients. Signiﬁcant diﬀerences have been observed in CRC tissue microbial clades, with a rise of the Fusobacterium genus. In addition, signiﬁcant taxa increase at the genus level has been observed in stool samples of CRC patients. Furthermore, Fusobacterium found in intestinal tissue has been positively correlated with fecal Parvimonas, for the ﬁrst time. Moreover, as predicted by metagenomics pathway analysis, a signiﬁcant increase of lactate (p=0.037) has been observed in the CRC fecal metabolic proﬁles, and positively correlated with Biﬁdobacterium (p=0.036). Finally, minor bacterial diﬀerences in CRC patients at stage T2 (TNM classiﬁcation) have been detected, with a raise of the Spirochaetota phylum in CRC samples, with a slight increase of the Alphaproteobacteria class in fecal samples.
Conclusion: Our results suggest the import

FAQs

What is the study’s main goal regarding adenoma to CRC progression?

To identify potential microbial and metabolic biomarkers that distinguish human CRC from adenomatous polyps and discriminate different CRC TNM stages using an integrated evaluation of multiple gastrointestinal niches.

Which samples and patient groups were included in the observational study?

Saliva, tissue, and stool samples were collected from 61 patients undergoing surgery in 2018, including 46 CRC and 15 AP patients matched by age and sex.

What key microbial and metabolite differences were reported between CRC and AP?

CRC patients showed different tissue and fecal microbiota profiles, including increased Fusobacterium, and CRC fecal metabolic profiles with a significant lactate increase correlated with Bi﬽obacterium.

Sep 24, 2026

Uploaded by Liam