title: Profile of Gut Microbiota Associated With the Presence of Hepatocellular Cancer in Patients With Liver Cirrhosis.
abstract: BACKGROUND
  Changes within the gut microbiota contribute to the progression of chronic liver diseases. According to the results of several studies performed in animal models, gut dysbiosis plays an important role in hepatocarcinogenesis. The aim of this study was to explore the characteristics of gut microbiota associated with the presence of hepatocellular cancer (HCC) in patients with cirrhosis of the liver undergoing liver transplantation.
  
  
  METHODS
  A total of 15 patients with HCC and 15 non-HCC patients matched according to etiology of cirrhosis and Model for End-Stage Liver Disease (MELD) scores who underwent liver transplantations between 2012 and 2014 were included. Analysis of their gut microbial profile was based on prospectively collected stool samples from the pretransplant period.
  
  
  RESULTS
  Patients with and without HCC were similar with respect to age (P = .506), sex (P = .700), hepatitis C virus (P > .999) and hepatitis B virus (P = .715) infection status, alcoholic liver disease (P > .999), and MELD score (P = .337). Notably, the presence of HCC was associated with significantly increased fecal counts of Escherichia coli (P = .025). Prediction of HCC presence based on E coli counts was associated with the area under the receiver-operating curve of 0.742 (95% confidence interval, 0.564-0.920), with the optimal cutoff on the level of 17.728 (natural logarithm of colony-forming units per 1 g of feces). Sensitivity and specificity rates for the established cutoff were 66.7% and 73.3%, respectively.
  
  
  CONCLUSIONS
  The profile of gut microbiota associated with the presence of HCC in cirrhotic patients is characterized by increased fecal counts of E coli. Therefore, intestinal overgrowth of E coli may contribute to the process of hepatocarcinogenesis.
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Electronic address: michal.grat@gmail.com.
authors: M
authors: M
authors: Grąt
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: K M
authors: KM
authors: Wronka
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: M
authors: M
authors: Krasnodębski
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: Ł
authors: Ł
authors: Masior
authors: Department of Epidemiology, Medical University of Warsaw, Warsaw, Poland.
authors: Z
authors: Z
authors: Lewandowski
authors: Department of Preventive Medicine and Hygiene, Medical University of Warsaw, Warsaw, Poland.
authors: I
authors: I
authors: Kosińska
authors: Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland.
authors: K
authors: K
authors: Grąt
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: J
authors: J
authors: Stypułkowski
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: S
authors: S
authors: Rejowski
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: M
authors: M
authors: Wasilewicz
authors: Institute of Microecology, Poznań, Poland.
authors: M
authors: M
authors: Gałęcka
authors: Institute of Microecology, Poznań, Poland.
authors: P
authors: P
authors: Szachta
authors: Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
authors: M
authors: M
authors: Krawczyk
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D004926:Escherichia coli; D005260:Female; D000069196:Gastrointestinal Microbiome; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000382:microbiology*; D008113:Liver Neoplasms / Q000382:microbiology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged