Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France.
World J Gastroenterol. 2018 Jun 14;24(22):2327-2347. doi: 10.3748/wjg.v24.i22.2327.
Colorectal cancer (CRC) is the second leading cause of cancer worldwide. CRC is still associated with a poor prognosis among patients with advanced disease. On the contrary, due to its slow progression from detectable precancerous lesions, the prognosis for patients with early stages of CRC is encouraging. While most robust methods are invasive and costly, actual patient-friendly screening methods for CRC suffer of lack of sensitivity and specificity. Therefore, the development of sensitive, non-invasive and cost-effective methods for CRC detection and prognosis are necessary for increasing the chances of a cure. Beyond its beneficial functions for the host, increasing evidence suggests that the intestinal microbiota is a key factor associated with carcinogenesis. Many clinical studies have reported a disruption in the gut microbiota balance and an alteration in the faecal metabolome of CRC patients, suggesting the potential use of a microbial-based test as a non-invasive diagnostic and/or prognostic tool for CRC screening. This review aims to discuss the microbial signatures associated with CRC known to date, including dysbiosis and faecal metabolome alterations, and the potential use of microbial variation markers for non-invasive early diagnosis and/or prognostic assessment of CRC and advanced adenomas. We will finally discuss the possible use of these markers as predicators for treatment response and their limitations.
结直肠癌(CRC)是全球第二大癌症病因。对于晚期疾病患者,CRC 仍然与预后不良相关。相反,由于其从可检测的癌前病变缓慢进展,CRC 早期患者的预后令人鼓舞。虽然大多数最有效的方法具有侵入性和高成本,但 CRC 的实际患者友好型筛查方法存在敏感性和特异性不足的问题。因此,需要开发敏感、非侵入性且具有成本效益的 CRC 检测和预后方法,以增加治愈的机会。除了对宿主有益的功能外,越来越多的证据表明肠道微生物群是与癌变相关的关键因素。许多临床研究报告了 CRC 患者肠道微生物群平衡的破坏和粪便代谢组的改变,这表明微生物测试可能作为 CRC 筛查的非侵入性诊断和/或预后工具。本综述旨在讨论迄今为止已知与 CRC 相关的微生物特征,包括肠道菌群失调和粪便代谢组改变,以及微生物变异标志物在 CRC 和高级腺瘤的非侵入性早期诊断和/或预后评估中的潜在用途。我们将最后讨论这些标志物作为治疗反应预测因子的可能用途及其局限性。