Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
Gastroenterology. 2022 Apr;162(5):1409-1423.e1. doi: 10.1053/j.gastro.2021.12.287. Epub 2022 Jan 6.
Current noninvasive methods for colorectal cancer (CRC) screening are not optimized for persons with inflammatory bowel diseases (IBDs), requiring patients to undergo frequent interval screening via colonoscopy. Although colonoscopy-based screening reduces CRC incidence in IBD patients, rates of interval CRC remain relatively high, highlighting the need for more targeted approaches. In recent years, the discovery of disease-specific microbiome signatures for both IBD and CRC has begun to emerge, suggesting that stool-based biomarker detection using metagenomics and other culture-independent technologies may be useful for personalized, early, noninvasive CRC screening in IBD patients. Here we discuss the utility of the stool microbiome as a noninvasive CRC screening tool. Comparing the performance of multiple microbiome-based CRC classifiers, including several multi-cohort meta-analyses, we find that noninvasive detection of colorectal adenomas and carcinomas from microbial biomarkers is an active area of study with promising early results.
目前用于结直肠癌（CRC）筛查的非侵入性方法并不适用于炎症性肠病（IBD）患者，这要求患者通过结肠镜检查进行频繁的间隔筛查。虽然基于结肠镜检查的筛查降低了 IBD 患者的 CRC 发病率，但间隔期 CRC 的发生率仍然相对较高，这凸显了需要更有针对性的方法。近年来，IBD 和 CRC 的疾病特异性微生物组特征的发现开始出现，这表明使用宏基因组学和其他非培养依赖技术的粪便生物标志物检测可能对 IBD 患者的个性化、早期、非侵入性 CRC 筛查有用。在这里，我们讨论了粪便微生物组作为非侵入性 CRC 筛查工具的效用。通过比较多个基于微生物组的 CRC 分类器的性能，包括几项多队列荟萃分析，我们发现从微生物生物标志物中无创检测结直肠腺瘤和癌是一个活跃的研究领域，具有有前途的早期结果。
