Thématique :
- Pancréas/Voies biliaires
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
Nom du veilleur :
Professeur Vinciane REBOURS
Coup de coeur :
  2018 Jan;67(1):120-127.  
  doi: 10.1136/gutjnl-2016-312580.  
  Human oral microbiome and prospective risk for pancreatic cancer: a population-based nested case-control study  
  Fan X, Alekseyenko AV, Wu J, Peters BA, Jacobs EJ, Gapstur SM, Purdue MP, Abnet CC, Stolzenberg-Solomon R, Miller G, Ravel J, Hayes RB, Ahn J  



A history of periodontal disease and the presence of circulating antibodies to selected oral pathogens have been associated with increased risk of pancreatic cancer; however, direct relationships of oral microbes with pancreatic cancer have not been evaluated in prospective studies. We examine the relationship of oral microbiota with subsequent risk of pancreatic cancer in a large nested case-control study.


We selected 361 incident adenocarcinoma of pancreas and 371 matched controls from two prospective cohort studies, the American Cancer Society Cancer Prevention Study II and the National Cancer Institute Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. From pre-diagnostic oral wash samples, we characterised the composition of the oral microbiota using bacterial 16S ribosomal RNA (16S rRNA) gene sequencing. The associations between oral microbiota and risk of pancreatic cancer, controlling for the random effect of cohorts and other covariates, were examined using traditional and L1-penalised least absolute shrinkage and selection operator logistic regression.


Carriage of oral pathogens, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, were associated with higher risk of pancreatic cancer (adjusted OR for presence vs absence=1.60 and 95% CI 1.15 to 2.22; OR=2.20 and 95% CI 1.16 to 4.18, respectively). Phylum Fusobacteria and its genus Leptotrichia were associated with decreased pancreatic cancer risk (OR per per cent increase of relative abundance=0.94 and 95% CI 0.89 to 0.99; OR=0.87 and 95% CI 0.79 to 0.95, respectively). Risks related to these phylotypes remained after exclusion of cases that developed within 2 years of sample collection, reducing the likelihood of reverse causation in this prospective study.


This study provides supportive evidence that oral microbiota may play a role in the aetiology of pancreatic cancer.


Question posée
Le microbiote oral (parodontite) est-il facteur de risque d'adénocarcinome du pancréas (ADKP)?
Question posée
Etude cas -contrôle nichée au sein de 2 cohortes de suivi prospectif. Patients inclus: 361 ADKP et 371 patients témoins apparentés. oral La présence des pathogènes (Porphyromonas gingivalis et Aggregatibacter actinomycetemcomitans), était associée à une sur-risque d'ADKP OR=1.60 (1.15-2.22) et OR=2.20 (1.16-4.18). A contrario, Phylum Fusobacteria et genus Leptotrichia étaient associés à une diminution du risque de cancer, OR=0.94 (0.89-0.99) et OR=0.87 (0.79-0.95).

Ces résultats confirment les données d’une première étude publiée auparavant, évoquant le rôle du microbiote dans la survenue du cancer du pancréas. Comme dans de nombreuses maladies et pour (presque) tous les organes, l’intérêt du microbiote et son rôle possible physiopathologique est encore mis en avant.