{
  "abstract": "Background The development of gastric cancer follows the Correa cascade model. Although Helicobacter pylori (Hp) is a major factor for this cascade, it often exhibits an abnormal depletion trend as the pathology progresses to gastric cancer, while Streptococcus undergoes remodeling and has been discovered to possess independent pro-carcinogenic capabilities. However, there is a lack of systematic, integrated research regarding the succession patterns of the gastric mucosal microbiome across the Correa cascade stages, particularly the pathogenic heterogeneity and contribution mechanisms of Streptococcus under different Hp infection statuses.Methods This study integrated 16S rRNA gene sequencing data of 981 gastric antrum mucosal samples from 7 Chinese cohorts. Samples were classified into 12 disease groups based on Hp infection status and pathological stage. Following standardized data preprocessing, we analyzed microbiome diversity and community structural differences. Furthermore, Random Forest (RF) machine learning models were constructed to evaluate the predictive discriminative capacity of the microbiota across different pathological stages, and the Shapley Additive Explanations (SHAP) was applied to elucidate the directional impact and relative importance of key bacteria, notably Streptococcus, within the models.Results Hp infection is the primary driver reshaping the gastric antrum microbiome, leading to a significant decrease in species diversity and a highly concentrated community dominated by Helicobacteraceae. However, after controlling for Hp, different pathological states still exert independent remodeling effects on the microbial structure. RF models demonstrated that stratification by Hp infection status improved predictive performance (AUC > 0.90 for Hp-positive and AUC > 0.85 for Hp-negative groups). SHAP analysis revealed the stage-specificity of Streptococcus: in Hp-negative backgrounds, its elevated abundance correlated primarily with predicting atrophic gastritis; conversely, in Hp-positive backgrounds, its high abundance strongly associated with predicting tumor states.Conclusions Hp infection determines the macroscopic structure of the gastric antrum microbiome and exerts a signal amplification effect within its dominant ecological niche, making disease-associated microbial signatures more discernible. Streptococcus exhibits stage-specific pathogenic potential in the Correa cascade. It may be associated with chronic mucosal atrophy in Hp-negative environments, while potentially exerting a synergistic effect with Hp in Hp-positive backgrounds to enhance tumor-related microenvironmental features.",
  "authors": [
    {
      "affiliations": [
        "Nanfang Hospital, Southern Medical University, Guangzhou, China"
      ],
      "name": "Haoyuan Xie"
    },
    {
      "affiliations": [
        "Nanfang Hospital, Southern Medical University, Guangzhou, China"
      ],
      "name": "Maoyuan Wang"
    },
    {
      "affiliations": [
        "Nanfang Hospital, Southern Medical University, Guangzhou, China"
      ],
      "name": "Xiling Chen"
    },
    {
      "affiliations": [
        "Department of Microbiology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China"
      ],
      "name": "Hao Huang"
    },
    {
      "affiliations": [
        "Department of Microbiology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China"
      ],
      "name": "Jian Xie"
    },
    {
      "affiliations": [
        "Nanfang Hospital, Southern Medical University, Guangzhou, China"
      ],
      "name": "Yang Bai"
    },
    {
      "affiliations": [
        "Department of Microbiology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China"
      ],
      "name": "Hongying Fan"
    }
  ],
  "title": "IDDF2026-ABS-0181 Gastric antrum microbiome succession and stage-specific associations of streptococcus in the correa cascade",
  "uid": "da0d0d58-c3c5-5378-a7be-e00d53e8e9b2"
}