Jeffery Cheah School of Medicine and Health Sciences, Monash University, Malaysia.
Department of Otolaryngology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
Crit Rev Oncol Hematol. 2024 Oct;202:104468. doi: 10.1016/j.critrevonc.2024.104468. Epub 2024 Aug 3.
This study elucidates the intricate relationship between nasopharyngeal carcinoma (NPC), a significant malignancy predominant in Asia with notable global incidence and mortality rates, and the host microbiota, including those of tumour, nasal, nasopharyngeal, oral, oropharyngeal, and gut communities. It underscores how the composition and diversity of microbiota are altered in NPC, delving into their implications for disease pathogenesis, treatment response, and the side effects of therapies. A consistent reduction in alpha diversity across oral, nasal, and gut microbiomes in NPC patients compared to healthy individuals signals a distinct microbial signature indicative of the diseased state. The study also shows unique microbial changes tied to different NPC stages, indicating a dynamic interplay between disease progression and microbiota composition. Patients with specific microbial profiles exhibit varied responses to chemotherapy and immunotherapy, underscoring the potential for treatment personalisation based on microbiota analysis. Furthermore, the side effects of NPC treatments, such as oral mucositis, are intensified by shifts in microbial communities, suggesting a direct link between microbiota composition and treatment tolerance. This nexus offers opportunities for interventions aimed at modulating the microbiota to alleviate side effects, improve quality of life, and potentially enhance treatment efficacy. Highlighting the dual potential of microbiota as both a therapeutic target and a biomarker for NPC, this review emphasises its significance in influencing treatment outcomes and side effects, heralding a new era in NPC management through personalised treatment strategies and innovative approaches.
本研究阐明了鼻咽癌（NPC）与宿主微生物群之间复杂的关系，包括肿瘤、鼻腔、鼻咽、口腔、口咽和肠道微生物群。研究强调了微生物群的组成和多样性在 NPC 中的变化，深入探讨了其对疾病发病机制、治疗反应和治疗副作用的影响。与健康个体相比，NPC 患者的口腔、鼻腔和肠道微生物群的 alpha 多样性普遍降低，表明存在明显的微生物特征，表明处于疾病状态。该研究还显示了与不同 NPC 阶段相关的独特微生物变化，表明疾病进展和微生物组成之间存在动态相互作用。具有特定微生物特征的患者对化疗和免疫疗法的反应不同，这表明基于微生物分析进行治疗个体化的潜力。此外，NPC 治疗的副作用，如口腔粘膜炎，会因微生物群落的变化而加剧，这表明微生物组成与治疗耐受性之间存在直接联系。这种联系为干预措施提供了机会，旨在调节微生物群以减轻副作用、提高生活质量，并可能增强治疗效果。本综述强调了微生物群作为 NPC 的治疗靶点和生物标志物的双重潜力，强调了其在影响治疗结果和副作用方面的重要性，通过个性化治疗策略和创新方法预示着 NPC 管理的新时代。
