PDF(Pubmed)
Abstract：
We investigated the prognostic role of the gut microbiome and clinical factors in chronic liver disease (hepatitis, cirrhosis, and hepatocellular carcinoma [HCC]). Utilizing data from 227 patients whose stool samples were collected over the prior 3 years and a Cox proportional hazards model, we integrated clinical attributes and microbiome composition based on 16S ribosomal RNA sequencing. HCC was the primary cause of mortality, with the Barcelona Clinic Liver Cancer staging system-derived B/C significantly increasing the mortality risk (hazard ratio [HR] = 8.060; 95% confidence interval [CI]: 3.6509-17.793; p < 0.001). Cholesterol levels < 140 mg/dL were associated with higher mortality rates (HR = 4.411; 95% CI: 2.0151-9.6555; p < 0.001). Incertae sedis from Ruminococcaceae showed a protective effect, reducing mortality risk (HR = 0.289; 95% CI: 0.1282 to 0.6538; p = 0.002), whereas increased Veillonella presence was associated with a higher risk (HR = 2.733; 95% CI: 1.1922-6.2664; p = 0.017). The potential of specific bacterial taxa as independent prognostic factors suggests that integrating microbiome data could improve the prognosis and treatment of chronic liver disease. These microbiome-derived markers have prognostic significance independently and in conjunction with clinical factors, suggesting their utility in improving a patient\'s prognosis.
摘要：
我们调查了慢性肝病（肝炎，肝硬化,和肝细胞癌[HCC])。利用先前3年收集的227名患者的粪便样本数据和Cox比例风险模型，我们基于16S核糖体RNA测序整合了临床属性和微生物组组成。肝癌是死亡的主要原因，与巴塞罗那诊所肝癌分期系统衍生的B/C显着增加死亡风险（风险比[HR]=8.060;95％置信区间[CI]：3.6509-17.793;p<0.001）。胆固醇水平<140mg/dL与较高的死亡率相关(HR=4.411;95%CI:2.0151-9.6555;p<0.001)。来自Ruminococaceae的Incertaesedis显示出保护作用，降低死亡风险(HR=0.289；95%CI：0.1282至0.6538；p=0.002)，而Veillonella的增加与较高的风险相关(HR=2.733;95%CI:1.1922-6.2664;p=0.017)。特定细菌分类群作为独立预后因素的潜力表明，整合微生物组数据可以改善慢性肝病的预后和治疗。这些微生物组来源的标志物具有独立的预后意义，并结合临床因素，表明它们在改善患者预后方面的效用。
