Klin Onkol. 2024;37(1):20-26. doi: 10.48095/ccko202420.
The incidence of pancreatic cancer (pancreatic ductal adenocarcinoma - PDAC) is increasing, especially in developed countries. In 2021, 496,000 new PDAC cases were dia-gnosed worldwide. In the Czech Republic, the incidence is one of the highest in the world, with 2,332 new PDAC patients dia-gnosed in 2018. Due to the absence of symptoms in the early stages, approximately 50% of patients are initially dia-gnosed with distant metastases. Mortality is slightly lower than the incidence count and, despite significant advances in cancer research, PDAC remains a fatal dia-gnosis. However, microbio-me seems to be an interesting approach, and not only in PDAC patients. Microbio-me is defined as the set of all microorganisms (microbio-ta, i.e. bacteria, fungi, viruses, archaea, and protozoa) and their genome in a certain environment. In a physiological setting, the gut microbio-me is in symbio-sis with the host organism, maintaining the balance of metabolism, mucosal immunomodulation and regulating the digestion process. When dysregulation of the number or function of intestinal microorganisms occurs, dysbio-sis is developed. It may lead to metabolic and cardiovascular diseases, nervous system disorders, induction of intestinal inflammation, or carcinogenesis. Microbio-ta can induce carcinogenesis in multiple ways, such as by activating an inflammatory response, reducing the immune system's ability to eliminate damaged cells, and deregulation of the host genome by microbial metabolites. This deregulation may lead to an activation of pro-apoptotic and pro-proliferative proteins. To date, research shows that the gut or oral microbio-me may be involved in the development of PDAC. One of the most studied bacteria is Porphyromonas gingivalis. Other bacteria, such as Fusobacteria, Enterobacter, Klebsiella, Prevotella, and Rothia, have also been shown to play a role in PDAC.
The aim of this review article is to point out one of the possible mechanisms of cancerogenesis in PDAC patients and its therapeutic influence to reduce the incidence and improve the prognosis of this aggressive disease.
胰腺癌（胰腺导管腺癌-PDAC）的发病率正在上升，尤其是在发达国家。2021 年，全球诊断出 49.6 万例新的 PDAC 病例。在捷克共和国，发病率位居世界前列，2018 年诊断出 2332 例新的 PDAC 患者。由于早期无症状，约有 50%的患者最初被诊断为远处转移。死亡率略低于发病率，尽管癌症研究取得了重大进展，但 PDAC 仍然是一种致命的诊断。然而，微生物组似乎是一种有趣的方法，不仅在 PDAC 患者中如此。微生物组被定义为特定环境中所有微生物（微生物群，即细菌、真菌、病毒、古细菌和原生动物）及其基因组。在生理环境中，肠道微生物组与宿主生物体共生，维持代谢平衡、粘膜免疫调节和调节消化过程。当肠道微生物数量或功能失调时，就会发生失调。它可能导致代谢和心血管疾病、神经系统疾病、肠道炎症的诱导或癌变。微生物可以通过多种方式诱导癌变，例如激活炎症反应、降低免疫系统消除受损细胞的能力以及微生物代谢物对宿主基因组的失调。这种失调可能导致促凋亡和促增殖蛋白的激活。迄今为止，研究表明肠道或口腔微生物组可能参与了 PDAC 的发展。研究最多的细菌之一是牙龈卟啉单胞菌。其他细菌，如梭杆菌、肠杆菌、克雷伯氏菌、普雷沃氏菌和罗氏菌，也被证明在 PDAC 中起作用。
本文旨在指出 PDAC 患者癌症发生的一种可能机制及其治疗影响，以降低这种侵袭性疾病的发病率并改善其预后。
