Detection of Fusobacterium nucleatum in Colorectal Adenomas Reveals Associations with Immune Molecular Signatures.

Fusobacterium nucleatum has been implicated in colorectal cancer, but its role in adenomas remains unclear. We applied an RNA-based detection of F. nucleatum in formalin-fixed paraffin-embedded adenoma tissue and explored the mutational landscape and transcriptomic profile of F. nucleatum+ patients in comparison to F. nucleatum- patients. Bespoke F. nucleatum probes successfully detected F. nucleatum in 11% of adenomas. F. nucleatum+ patients exhibited a positively enriched anti-bacterial defence response and immune-related transcriptomic signatures, as well as a proliferative profile. These findings suggest that F. nucleatum positivity is associated with immune and proliferative transcriptomic signatures in colorectal adenomas, but this requires validation in larger, longitudinal cohorts.