Dr Jonathan LEE National University Hospital Singapore Link to biosketch

Abstract

Micro-organisms, in particular, Helicobacter pylori (H. pylori), play a crucial role in gastric cancer (GC) carcinogenesis. Yet only <5% of patients infected withH. pylori develop GC. Previous studies have demonstrated that non-H. pylorimicrobes also play an important role in the development of GC. However, there have been few prospective studies, with repeated sampling of the gastric mucosa, to investigate metagenomic changes prior to GC. In this talk, we will highlight that sequencing identified more patients withH. pylori compared with histopathology and H. pylori was also significantly enriched in early GC. Our findings also demonstrate that patients progressing from gastric intestinal metaplasia to GC demonstrate an enrichment of Proteobacteria (in particular Proteus genus) and depletion of Bacteriodetes (S24-7 family). Finally, we developed a model, using 6 microbial taxonomic features, to best predict patients at risk of subsequent GC (AUROC = 0.82). We thereby believe microbiome sequencing may complement histopathology to increase detection ofH. pylori, and there be a role for prospective microbiome monitoring to monitor at-risk patients for GC.