Liu Yi-Cheng, Tang Xiang-Yi, Lang Ji-Xuan, Qiu Yue, Chen Ye, Li Xin-Yun, Cao Yu, Zhang Chun-Dong
Clinical Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China.
Department of Surgical Oncology, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China.
J Transl Med. 2025 Jun 18;23(1):682. doi: 10.1186/s12967-025-06727-5.
Increasing evidence suggests that the gut microbiome may play an important role in the development of colorectal tumors. Antibiotic use can affect the gut microbiome and may increase the risks of benign and malignant colorectal tumors.
Eligible studies assessing the relationship between antibiotic exposure and the risk of developing benign or malignant colorectal tumors were identified. Odds ratios (ORs) were pooled for antibiotic use versus no use using a random-effects model. Further subgroup and sensitivity analyses were conducted to confirm the consistence and robustness of the main findings. The study protocol was registered with PROSPERO.
Twenty-three studies including 1,145,853 participants were finally included in the analysis. People who had used antibiotics had a 13% increased risk of colorectal tumors compared with those who had never used antibiotics [OR: 1.13; 95% confidence interval (CI) 1.04-1.22; P < 0.01]. Subgroup analysis showed that antibiotic exposure was associated with increased risks of both benign (OR: 1.13; 95% CI 1.00-1.27; P < 0.01) and malignant colorectal tumors (OR: 1.13; 95% CI 1.03-1.23; P < 0.01). In addition, colorectal tumor risk was significantly increased by antibiotic exposure, especially the use of combined antibiotics and a longer period after antibiotic exposure. The main findings were consistent and robust across most subgroups and sensitivity analyses.
The current findings suggested that antibiotic use increased the risk of developing benign or malignant colorectal tumors. These results highlighted the need for clinicians to prescribe antibiotics cautiously, to reduce colorectal cancer risk.
越来越多的证据表明，肠道微生物群可能在结直肠肿瘤的发生发展中起重要作用。抗生素的使用会影响肠道微生物群，并可能增加良性和恶性结直肠肿瘤的风险。
确定了评估抗生素暴露与发生良性或恶性结直肠肿瘤风险之间关系的合格研究。使用随机效应模型汇总抗生素使用与未使用抗生素的比值比（OR）。进行了进一步的亚组分析和敏感性分析，以确认主要发现的一致性和稳健性。该研究方案已在国际前瞻性系统评价注册库（PROSPERO）登记。
最终纳入分析的有23项研究，共1,145,853名参与者。与从未使用过抗生素的人相比，使用过抗生素的人患结直肠肿瘤的风险增加了13%[OR：1.13；95%置信区间（CI）1.04 - 1.22；P < 0.01]。亚组分析表明，抗生素暴露与良性（OR：1.13；95%CI 1.00 - 1.27；P < 0.01）和恶性结直肠肿瘤（OR：1.13；95%CI 1.03 - 1.23；P < 0.01）的风险增加均相关。此外，抗生素暴露，尤其是联合使用抗生素以及抗生素暴露后的较长时间，会显著增加结直肠肿瘤风险。在大多数亚组分析和敏感性分析中，主要发现具有一致性和稳健性。
目前的研究结果表明，使用抗生素会增加发生良性或恶性结直肠肿瘤的风险。这些结果凸显了临床医生谨慎开具抗生素处方以降低结直肠癌风险的必要性。
