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Review
. 2024 Apr 29;16(4):e59251.
doi: 10.7759/cureus.59251. eCollection 2024 Apr.

Association of Periodontal Red Complex Bacteria With the Incidence of Gastrointestinal Cancers: A Systematic Review and Meta-Analysis

Sriram Kaliamoorthy  1 , Sugantha Priya Sayeeram  2 , N Gowdhaman  3 , Merlin Jayaraj  4 , B Radhika  5 , Sugirtha Chellapandi  5 , Agila Elumalai  5 , Sai P Archana  6 , Kanmani Raju  6 , Santosh Palla  7
Affiliations
Review

Association of Periodontal Red Complex Bacteria With the Incidence of Gastrointestinal Cancers: A Systematic Review and Meta-Analysis

Sriram Kaliamoorthy et al. Cureus. .

Abstract

Porphyromonas gingivalis is the primary microbe in the "periodontal red complex" bacteria (PRCB) along with Tannerella forsythia and Treponema denticola, which are linked to periodontal disease (PD). These pathogens are also implicated in various systemic disorders, but their association with the incidence of gastrointestinal (GI) cancer is less explored. A systematic review followed by a meta-analysis was conducted as per standard guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2022) to find this association between GI cancers and PRCB after a literature search for full-text papers in the English language (between 2010 and 2023) in databases (Cochrane Library, PubMed, and Web of Science) with suitable keywords using the Boolean search strategy. Data extraction involved titles, abstracts, and full texts retrieved and scored by the modified Newcastle-Ottawa Scale. The data were analyzed by the Review Manager (RevMan 5.2, Cochrane Collaboration, Denmark). Standard Cochran Q test and I2 statistics (for heterogeneity) and a random effects model (pooled OR with 95% CI) were applied to report results. P. gingivalis among the PRCB was linked to GI cancers (OR: 2.16; 95% CI: 1.34-3.47). T. forsythia and T. denticola did not show meaningful associations as per existing evidence for GI cancers.

Keywords: gastrointestinal cancers; oral cancer; p.gingivalis; periodontitis; red complex microbes.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flow diagram
GI, gastrointestinal; PRCB, periodontal red-complex bacteria; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analysis
Figure 2
Figure 2. Forest plot showing the association of P. gingivalis with the incidence of gastrointestinal (GI) cancers
Forest plot showing individual OR (black boxes) taken from selected studies (on the y-axis) and range (x-axis) for associating P. gingivalis with the incidence of GI cancers. The sum effect or pooled OR derived was OR; 95%CI, P) = [1.86(1.20,2.88) P = 0.001] (white diamond mark).
Figure 3
Figure 3. Forest plot showing the association of T. forsythia with the incidence of gastrointestinal (GI) cancers
Forest plot showing individual OR (black boxes) taken from selected studies (on the y-axis) and range (x-axis) for associating T. forsythia with the incidence of GI cancers. The sum effect or pooled OR derived was OR; 95% CI, P) = [1.06 (95% CI, 0.8-1.44) P = 1.0] (white diamond mark).
Figure 4
Figure 4. Forest plot showing the association of T. denticola with the incidence of gastrointestinal (GI) cancers
Forest plot showing individual OR (black boxes) taken from selected studies (on the y-axis) and range (x-axis) for associating T. denticola with the incidence of GI cancers. The sum effect or pooled OR derived was [OR; 95%CI, P) = [1.31(0.97-1.71) P = 0.6] (white diamond mark).
Figure 5
Figure 5. Assessments of risk of bias for studies/publications
The Begg and Egger regression intercept test indicated no potential publication bias for the incidence of GI cancers (0.091). A two-tailed *P < 0.05 was considered statistically significant. GI, gastrointestinal
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