Institute of Digestive Disease and Department of Medicine and Therapeutics, State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
CUHK Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, People's Republic of China.
Nat Rev Gastroenterol Hepatol. 2019 Nov;16(11):690-704. doi: 10.1038/s41575-019-0209-8. Epub 2019 Sep 25.
Colorectal cancer (CRC) accounts for about 10% of all new cancer cases globally. Located at close proximity to the colorectal epithelium, the gut microbiota comprises a large population of microorganisms that interact with host cells to regulate many physiological processes, such as energy harvest, metabolism and immune response. Sequencing studies have revealed microbial compositional and ecological changes in patients with CRC, whereas functional studies in animal models have pinpointed the roles of several bacteria in colorectal carcinogenesis, including Fusobacterium nucleatum and certain strains of Escherichia coli and Bacteroides fragilis. These findings give new opportunities to take advantage of our knowledge on the gut microbiota for clinical applications, such as gut microbiota analysis as screening, prognostic or predictive biomarkers, or modulating microorganisms to prevent cancer, augment therapies and reduce adverse effects of treatment. This Review aims to provide an overview and discussion of the gut microbiota in colorectal neoplasia, including relevant mechanisms in microbiota-related carcinogenesis, the potential of utilizing the microbiota as CRC biomarkers, and the prospect for modulating the microbiota for CRC prevention or treatment. These scientific findings will pave the way to clinically translate the use of gut microbiota for CRC in the near future.
结直肠癌（CRC）约占全球所有新发癌症病例的 10%。肠道微生物群位于结直肠上皮附近，由大量与宿主细胞相互作用以调节许多生理过程的微生物组成，如能量收获、代谢和免疫反应。测序研究揭示了 CRC 患者的微生物组成和生态变化，而动物模型中的功能研究则确定了几种细菌在结直肠癌变中的作用，包括具核梭杆菌和某些大肠杆菌和脆弱拟杆菌菌株。这些发现为我们利用肠道微生物群的知识提供了新的机会，例如将肠道微生物群分析作为筛查、预后或预测生物标志物，或调节微生物以预防癌症、增强治疗效果和减少治疗的不良反应。本综述旨在概述和讨论结直肠肿瘤中的肠道微生物群，包括与微生物群相关的致癌机制、将微生物群用作 CRC 生物标志物的潜力，以及调节微生物群预防或治疗 CRC 的前景。这些科学发现将为在不久的将来将肠道微生物群在 CRC 中的临床应用铺平道路。
