Lactobacillus was the only genus significantly increased across neoplastic stages, and high abundance of Lactobacillus has previously been described in EAC tumors.15Streptococcus, the most abundant genus in the upper aero-digestive tract, was increased in BE and was associated with increased expression of growth factors FGF2 and HGF as well as IL6, a pro-inflammatory cytokine that likely plays a key role in promoting esophageal neoplasia.4 These findings are all consistent with a potential mechanistic role for bacteria in the development of EAC. The gene discussed is HGF; the disease is Barrett esophagus.