Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
Department of Surgery I, University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022 Mar;166(1):1-11. doi: 10.5507/bp.2021.054. Epub 2021 Nov 5.
Appropriate screening of early asymptomatic cases can reduce the disease burden and mortality rate of sporadic colorectal cancer (CRC) significantly. Currently, fecal occult blood testing (FOBT) is able to detect up to 80% of asymptomatic cases in the population aged 50+. Therefore, there is still a demand for new screening tests that would complement FOBT, mainly by detecting at least a part of the FOBT-negative CRC and adenoma cases, or possibly by identifying person at increased risk of sporadic CRC in order to offer them tailored follow-up. Among the potential markers studied, our knowledge has advanced at most in toxigenic gram-negative bacteria. In this review, we assess their potential critically and recommend those best suited for prospective evaluation of their true ability to increase the sensitivity of FOBT when combined during general population screening. In our opinion, colibactin and Bacteroides fragilis toxin are the best candidates, possibly complemented by the cytotoxic necrotizing factor (CNF).
适当的早期无症状病例筛查可以显著降低散发性结直肠癌（CRC）的疾病负担和死亡率。目前，粪便潜血检测（FOBT）能够检测出 50 岁以上人群中高达 80%的无症状病例。因此，仍然需要新的筛查试验来补充 FOBT，主要是通过检测至少一部分 FOBT 阴性的 CRC 和腺瘤病例，或者可能通过识别 CRC 风险增加的个体，以便为他们提供个性化的随访。在研究的潜在标志物中，我们对产毒革兰氏阴性菌的了解最多。在这篇综述中，我们批判性地评估了它们的潜力，并建议选择最适合前瞻性评估其与 FOBT 联合应用于一般人群筛查时提高敏感性的真正能力的标志物。在我们看来，大肠菌素和脆弱拟杆菌毒素是最好的候选者，可能还需要细胞毒性坏死因子（CNF）来补充。
