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Background <p>Poor oral health is an independent risk factor for upper-aerodigestive tract cancers, including esophageal squamous cell carcinoma (ESCC). <i>Porphyromonas gingivalis (P. gingivalis)</i>, the most studied periodontal pathogen, is a Gram-negative bacterium with walls composed of lipopolysaccharide (LPS). TLR4 recognizes LPS, and we previously reported that ESCC patients exhibiting high TLR4 expression also show significantly poorer survival than patients expressing lower levels of TLR4. We therefore hypothesized that <i>P. gingivalis</i> affects disease progression and prognosis in patients with ESCC.</p> Patients and methods <p>We used an ESCC tissue microarray to assess the <i>P. gingivalis</i> status of ESCC patients and to determine whether <i>P. gingivalis</i> levels correlate with prognosis after curative esophagectomy. We also tested whether the combined <i>P. gingivalis</i> and TLR4 statuses correlate with prognosis in these patients.</p> Results <p>Clinical ESCC samples from 175 patients were tested for <i>P. gingivalis</i>. High <i>P. gingivalis</i> levels (3 + and 2 +) correlated with significantly poorer 5-year overall survival (OS) and disease-specific survival (DSS) after esophagectomy than lower <i>P. gingivalis</i> levels (1 + and 0). Univariate and multivariate analyses showed that the <i>P. gingivalis</i> status is an independent prognostic factor affecting 5-year OS and DSS. Moreover, the combined <i>P. gingivalis</i> and TLR4 statuses are also an independent prognostic factor affecting 5-year OS and DSS.</p> Conclusion <p><i>P. gingivalis</i> levels correlates with TLR4 expression and predicts a poorer prognosis in ESCC patients after esophagectomy. Preventing <i>P. gingivalis</i> infection may be an effective strategy for improving the long-term outcomes of patients with ESCC.</p>

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Porphyromonas gingivalis levels correlate with TLR4 expression status and prognosis after esophagectomy for advanced thoracic esophageal squamous cell carcinoma

  • 期刊论文

  • 发表日期：

    2025年6月30日

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  • Takatoshi Yoneya,
  • Yusuke Sato,
  • Kyoko Nomura,
  • Akiyuki Wakita,
  • Yushi Nagaki,
  • Ryohei Sasamori,
  • Yoshihiro Sasaki,
  • Shu Nozaki,
  • Tsukasa Takahashi,
  • Munehiro Yamada,
  • Mayu Takahashi,
  • Kaori Terata,
  • Kazuhiro Imai

摘要

Background

Poor oral health is an independent risk factor for upper-aerodigestive tract cancers, including esophageal squamous cell carcinoma (ESCC). Porphyromonas gingivalis (P. gingivalis), the most studied periodontal pathogen, is a Gram-negative bacterium with walls composed of lipopolysaccharide (LPS). TLR4 recognizes LPS, and we previously reported that ESCC patients exhibiting high TLR4 expression also show significantly poorer survival than patients expressing lower levels of TLR4. We therefore hypothesized that P. gingivalis affects disease progression and prognosis in patients with ESCC.

Patients and methods

We used an ESCC tissue microarray to assess the P. gingivalis status of ESCC patients and to determine whether P. gingivalis levels correlate with prognosis after curative esophagectomy. We also tested whether the combined P. gingivalis and TLR4 statuses correlate with prognosis in these patients.

Results

Clinical ESCC samples from 175 patients were tested for P. gingivalis. High P. gingivalis levels (3 + and 2 +) correlated with significantly poorer 5-year overall survival (OS) and disease-specific survival (DSS) after esophagectomy than lower P. gingivalis levels (1 + and 0). Univariate and multivariate analyses showed that the P. gingivalis status is an independent prognostic factor affecting 5-year OS and DSS. Moreover, the combined P. gingivalis and TLR4 statuses are also an independent prognostic factor affecting 5-year OS and DSS.

Conclusion

P. gingivalis levels correlates with TLR4 expression and predicts a poorer prognosis in ESCC patients after esophagectomy. Preventing P. gingivalis infection may be an effective strategy for improving the long-term outcomes of patients with ESCC.