Fusobacterium nucleatum (Fn), a specific species of gut microbiota, has been suggested to be enriched in the
microsatellite instability-high (MSI-H) molecular subtype of
colorectal carcinomas (
CRCs). However, the clinicopathologic and molecular factors that interact with Fn in MSI-H
CRCs are poorly understood. In this study,
16S ribosomal RNA gene DNA sequence of Fn was quantitatively measured by real-time polymerase chain reaction in
tumor DNA samples from a total of 160 surgically resected MSI-H CRC tissues. Each case was classified into one of the three categories based on the Fn
DNA amount: Fn-high, Fn-low, and Fn-negative. The clinicopathologic and molecular associations of Fn in MSI-H
CRCs were statistically analyzed. Among the 160 MSI-H CRC samples, 15 (9%), 92 (58%), and 53 (33%) cases were Fn-high, Fn-low, and Fn-negative, respectively. Compared with Fn-low/negative
tumors, Fn-high MSI-H
CRCs were significantly associated with a high density of CD68+
tumor-infiltrating macrophages (P = 0.019) and promoter CpG island hypermethylation of the CDKN2A (p16) gene (P = 0.008). There were also tendencies toward associations of Fn-high with the BRAF V600E mutation (P = 0.047) and active Crohn-like lymphoid reactions (P = 0.052) in MSI-H
CRCs. However, Fn-high was not significantly associated with CD3+ T cell density, CD163+ M2 macrophage density or PD-L1 expression status. In conclusion, high amounts of intratumoral Fn are correlated with increased macrophage infiltration and CDKN2A promoter methylation in MSI-H
CRCs.