A correlational study of Weifuchun and its clinical effect on intestinal flora in precancerous lesions of gastric cancer

Yanqin Bian, Xi Chen, Hongyan Cao, Dong Xie, Meiping Zhu, Nong Yuan, Lu Lu, Bingjie Lu, Chao Wu, Nisma Lena Bahaji Azami, Zheng Wang, Huijun Wang, Yeqing Zhang, Kun Li, Guan Ye, Mingyu Sun, Yanqin Bian, Xi Chen, Hongyan Cao, Dong Xie, Meiping Zhu, Nong Yuan, Lu Lu, Bingjie Lu, Chao Wu, Nisma Lena Bahaji Azami, Zheng Wang, Huijun Wang, Yeqing Zhang, Kun Li, Guan Ye, Mingyu Sun

Abstract

Background: Weifuchun (WFC), a Chinese herbal prescription consisting of Red Ginseng, Isodon amethystoides and Fructus Aurantii, is commonly used in China to treat a variety of chronic stomach disorders. The aim of the paper was to determine the effect of WFC on intestinal microbiota changes in precancerous lesions of gastric cancer (PLGC) patients.

Methods: PLGC patients of H. pylori negative were randomly divided into two groups and received either WFC tablets for a dose of 1.44 g three times a day or vitacoenzyme (Vit) tablets for a dose of 0.8 g three times a day. All patients were treated for 6 months consecutively. Gastroscopy and histopathology were used to assess the histopathological changes in gastric tissues before and after treatment. 16S rRNA gene sequencing was carried out to assess the effects WFC on intestinal microbiota changes in PLGC patients. Receiver Operating Characteristics (ROC) analysis was used to assess the sensitivity and specificity of different intestinal microbiota in distinguishing between PLGC patients and healthy control group.

Results: Gastroscopy and histopathological results indicated that WFC could improve the pathological condition of PLGC patients, especially in the case of atrophy or intestinal metaplasia. The results of 16S rRNA gene sequencing indicated that WFC could regulate microbial diversity, microbial composition, and abundance of the intestinal microbiota of PLGC patients. Following WFC treatment, the relative abundance of Parabacteroides decreased in WFC group when compared with the Vit group. ROC analysis found that the Parabacteroides could effectively distinguish PLGC patients from healthy individuals with sensitivity of 0.79 and specificity of 0.8.

Conclusions: WFC could slow down the progression of PLGC by regulating intestinal microbiota abundance. Trial registration NCT03814629. Name of registry: Randomized Clinical Trial: Weifuchun Treatment on Precancerous Lesions of Gastric Cancer. Registered 3 August 2018-Retrospectively registered, https://register.clinicaltrials.gov/ NCT03814629.

Keywords: Intestinal microbiota; Precancerous lesions of gastric cancer; Randomized controlled clinical trial; Weifuchun.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Enrollment, Randomization, and Follow-up. Improvement from baseline in the grade of histopathology detected on gastroscopy at the 6-month follow-up was evaluated in the intention-to treat population. Only patients with gastric tissue specimens obtained at the 6-month follow-up were included in the histologic analysis
Fig. 2
Fig. 2
Histopathological Variation. A Endoscope variation. B Pathological staining in HE. C Pathological evaluation. WFC, Weifuchun Group; Vit, vitacoenzyme Group
Fig. 3
Fig. 3
Microbial profiles (mean relative proportion) of most abundant (> 1%) phyla, class and genera by comparison for groups. Health: healthy volunteers; WFCB: PLGC patients before treatment with WFC; WFCA: PLGC patients after treatment with WFC; VitB: PLGC patients before treatment with vitacoenzyme; VitA: PLGC patients after treatment with vitacoenzyme
Fig. 4
Fig. 4
Comparisons for bacterial abundance. Bacterial relative abundance differences were observed for 8 core genera in each group. TSS: Total -sum normalization. *, p 

Fig. 5

Receiver operating curve analysis for…

Fig. 5

Receiver operating curve analysis for selected microbial biomarker of PLGC. 8 selected microbial…

Fig. 5
Receiver operating curve analysis for selected microbial biomarker of PLGC. 8 selected microbial biomarkers of PLGC were tested by ROC analysis
Fig. 5
Fig. 5
Receiver operating curve analysis for selected microbial biomarker of PLGC. 8 selected microbial biomarkers of PLGC were tested by ROC analysis

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