Correlation between pre-chemotherapy gut microbiota characteristics and chemotherapy tolerance in postoperative colorectal cancer patients

Zheng Haiping; Wang Tongling; Ma Zhixiao; Yang Tao; Li Hai

doi:10.16689/j.cnki.cn11-9349/r.2026.01.016

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (1) : 118-125. DOI: 10.16689/j.cnki.cn11-9349/r.2026.01.016

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Correlation between pre-chemotherapy gut microbiota characteristics and chemotherapy tolerance in postoperative colorectal cancer patients

Zheng Haiping, Wang Tongling, Ma Zhixiao,Yang Tao, Li Hai

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Abstract

Objective To investigate the correlation between pre-chemotherapy gut microbiota diversity and chemotherapy tolerance in postoperative colorectal cancer patients. Method A total of 100 colorectal cancer patients who underwent surgical treatment at Department of Gastrointestinal and Hernia Surgery, Zhangjiakou First Hospital from August 2023 to June 2024 were enrolled. All patients received 6-8 cycles of mFOLFOX6 chemotherapy based on postoperative pathological findings. According to their tolerance during chemotherapy, patients were divided into a tolerant group and a non-tolerant group. High-throughput sequencing was used to analyze pre-chemotherapy fecal samples from both groups. The overall structure and diversity of gut microbiota were analyzed, and significantly different species between the two groups were compared. Result There were no significant differences in baseline clinical data between the two groups before chemotherapy (P>0.05). In terms of gut microbiota α-diversity, the tolerant group showed significantly higher Chao, ACE, and Shannon indices and a lower Simpson index compared to the non-tolerant group (P<0.05). β-diversity also differed significantly between the two groups (P<0.05). Multivariate logistic regression analysis revealed that pre-chemotherapy gut microbiota diversity indices, including Chao (OR=0.894), ACE (OR=0.929), Shannon (OR=0.726), and Simpson (OR=1.497), were independently associated with chemotherapy tolerance in colorectal cancer patients (P<0.05). In terms of gut microbiota composition, the tolerant group was predominantly dominated by Faecalibacterium, Bifidobacterium, Escherichia, Lactobacillus, and Parabacteroides; while the non-tolerant group was mainly dominated by Enterobacter, Fusobacterium, Bacteroides, Akkermansia, Clostridioides, and Cetobacterium. Conclusion Pre-chemotherapy gut microbiota diversity may be correlated with chemotherapy tolerance in colorectal cancer patients.

Key words

Colorectal cancer / Chemotherapy / Gut microbiota / Microbial community diversity / Differential species / High-throughput sequencing / Tolerance / Correlation

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Zheng Haiping, Wang Tongling, Ma Zhixiao,Yang Tao, Li Hai. Correlation between pre-chemotherapy gut microbiota characteristics and chemotherapy tolerance in postoperative colorectal cancer patients[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(1): 118-125 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.01.016

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