Okereke Ikenna, Hamilton Catherine, Wenholz Alison, Jala Vikram, Giang Thao, Reynolds Sandy, Miller Aaron, Pyles Richard
Division of Cardiothoracic Surgery, University of Texas Medical Branch, Galveston, TX, USA.
Division of Gastroenterology, University of Texas Medical Branch, Galveston, TX, USA.
J Thorac Dis. 2019 Aug;11(Suppl 12):S1588-S1593. doi: 10.21037/jtd.2019.05.82.
The incidence of esophageal diseases such as esophageal adenocarcinoma (EAC) and gastroesophageal reflux disease (GERD) have been increasing over the last 40 years. The esophageal microbiome appears to have a role in the development of some disease processes, and could also serve as markers of early diseases of the esophagus. A literature review was performed examining the role of the microbiome in the development of esophageal disease. In addition, the results of several studies and experiments were included in the review. Both EAC and GERD have increased in incidence over the last 40 years. Barrett's esophagus (BE) is a risk factor for EAC. Patients with BE appear to have a microbiome expression pattern distinct from patients without BE. The distinct pattern may be related to factors within the distal esophagus such as a more acidic environment, intraluminal stasis and other elements. It remains unclear whether the change in microflora leads to esophageal disease, or whether the disease process within the esophagus allows these particular organisms to experience overgrowth compared to other microflora. Patient factors such as body mass index (BMI), diet and geographic location also appear to affect the esophageal microbiome. There is an association with the esophageal microbiome and several esophageal diseases. Future studies should examine these correlations more closely. The distinct patterns may be able to serve as a marker of early disease, and possibly lead to a mechanism for the development of esophageal disease.
在过去40年里，诸如食管腺癌（EAC）和胃食管反流病（GERD）等食管疾病的发病率一直在上升。食管微生物群似乎在某些疾病进程的发展中发挥作用，也可能作为食管早期疾病的标志物。我们进行了一项文献综述，研究微生物群在食管疾病发展中的作用。此外，几项研究和实验的结果也纳入了该综述。在过去40年里，EAC和GERD的发病率均有所上升。巴雷特食管（BE）是EAC的一个危险因素。患有BE的患者似乎具有与未患BE的患者不同的微生物群表达模式。这种不同的模式可能与食管远端的因素有关，如酸性更强的环境、管腔内淤滞和其他因素。目前尚不清楚微生物群的变化是否会导致食管疾病，或者食管内的疾病进程是否会使这些特定微生物相对于其他微生物群过度生长。诸如体重指数（BMI）、饮食和地理位置等患者因素似乎也会影响食管微生物群。食管微生物群与几种食管疾病之间存在关联。未来的研究应更密切地研究这些相关性。这种不同的模式可能能够作为早期疾病的标志物，并可能导致食管疾病发展的一种机制。
