Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.
Cancer Early Detection Advanced Research (CEDAR), Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.
Clin Transl Gastroenterol. 2021 Aug 26;12(9):e00390. doi: 10.14309/ctg.0000000000000390.
Barrett's esophagus (BE) prevalence has increased steadily over the past several decades and continues to be the only known precursor of esophageal adenocarcinoma. The exact cause of BE is still unknown. Most evidence has linked BE to gastroesophageal reflux disease, which injures squamous esophageal mucosa and can result in the development of columnar epithelium with intestinal metaplasia. However, this relationship is inconsistent-not all patients with severe gastroesophageal reflux disease develop BE. There is increasing evidence that the host microbiome spanning the oral and esophageal environments differs in patients with and without BE. Several studies have documented the oral and esophageal microbiome's composition for BE with inconsistent findings. The scarcity and inconsistency of the literature and the dynamic phenomena of microbiota all warrant further studies to validate the findings and dissect the effects of oral microbiota, which are considered a viable proxy to represent esophageal microbiota by many researchers. This review aims to summarize the variability of the oral and esophageal microbiome in BE by using the example of Streptococcus to discuss the limitations of the current studies and suggest future directions. Further characterization of the sensitivity and specificity of the oral microbiome as a potential risk prediction or prevention marker of BE is critical, which will help develop noninvasive early detection methods for BE, esophageal adenocarcinoma, and other esophageal diseases.
巴雷特食管（BE）的患病率在过去几十年中稳步上升，并且仍然是唯一已知的食管腺癌前体。BE的确切病因仍不清楚。大多数证据将 BE 与胃食管反流病联系在一起，后者会损伤鳞状食管黏膜，并可能导致柱状上皮和肠上皮化生的发展。然而，这种关系并不一致——并非所有患有严重胃食管反流病的患者都会发展为 BE。越来越多的证据表明，跨越口腔和食管环境的宿主微生物组在 BE 患者和无 BE 患者中存在差异。几项研究记录了 BE 的口腔和食管微生物组的组成，但结果不一致。文献的稀缺性和不一致性以及微生物组的动态现象都需要进一步的研究来验证这些发现，并剖析口腔微生物组的作用，许多研究人员认为口腔微生物组是代表食管微生物组的可行替代物。本综述旨在通过使用链球菌为例，总结 BE 中口腔和食管微生物组的可变性，讨论当前研究的局限性，并提出未来的研究方向。进一步表征口腔微生物组作为 BE 的潜在风险预测或预防标志物的敏感性和特异性至关重要，这将有助于开发用于 BE、食管腺癌和其他食管疾病的非侵入性早期检测方法。
