Analysis of intestinal flora changes after cholecystectomy and its correlation with colorectal cancer

DONG Zhenyu; LI Xin; GUO Zhenping; JI Pengyu; DU Mingyue; GUO Jing; HOU Runjie; WANG Jijun

doi:10.3969/j.issn.1009-0460.2025.10.007

Abstract：Objective To explore the changes in intestinal flora in people after cholecystectomy and their correlation with colorectal cancer.Methods This study enrolled a total of 41 Han Chinese subjects from Baotou Central Hospital who had long-term residence in the Inner Mongolia Autonomous Region.From October 2022 to October 2023,their basic information and fecal samples were collected.This included 15 fecal samples from healthy individuals,designated as the healthy control group;16 fecal samples from patients who had undergone cholecystectomy 1-5 years prior,designated as the cholecystectomy group;and 10 fecal samples from colorectal cancer patients without a history of cholecystectomy,designated as the colorectal cancer group.16S rRNA gene sequencing technology was used to analyze the composition,richness and diversity of their intestinal flora,and the differences between groups were compared.Results A total of 3 293 390 high-quality sequences were obtained by sequencing,with good data coverage.At the phylum level,both the post-cholecystectomy group and the colorectal cancer group showed an increase in the relative abundance of Bacteroidota,Proteobacteria,Verrucomicrobiota and Fusobacteria,while the relative abundance of Actinobacteriota showed a decreasing trend.At the genus level,both groups showed increased abundances of Escherichia and Ruminococcus,While Faecalibacterium,Bifidobacterium,Collinsella,and Agathobacter were generally decreased.In addition,the post-cholecystectomy group independently exhibited a significant increase in Blautia and Gemmiger.The healthy control group had higher Chao1 index and Observed species index than the post-cholecystectomy group(P<0.05),and there was also a significant distinction in gut microbiota β-diversity between the healthy control group and the colorectal cancer group(P<0.05).In the inter-group comparison,Lachnospiraceae,Ruminococcus,Faecalimonas and Burkholderiaceae were the main marker flora in the post-cholecystectomy group;while the colorectal cancer group was mainly characterized by Porphyromonadaceae,Peptostreptococcus and Fusobacteriota.Further analysis showed that the abundances of Collinsella,Coriobacteriaceae,and Chloroflexota in the healthy control group were significantly higher than those in the post-cholecystectomy group.In contrast,the colorectal cancer group had higher abundances of Porphyromonas,Anaeroglobus,Fusobacterium,Peptostreptococcus,Ruthenibacterium,Peptoniphilus,Tissierella,and Micromonascompared with the post-cholecystectomy group.Conclusion The changes in intestinal flora composition in people 1-5 years after cholecystectomy are associated with an increased risk of colorectal cancer.Both groups show a trend of decreased bacteria producing short-chain fatty acids and probiotics,along with increased pathogenic bacteria.Additionally,colorectal cancer patients are also accompanied by a significant reduction in intestinal flora richness and separation of community structure.