Cintoni Marco, Palombaro Marta, Zoli Eleonora, D'Agostino Giuseppe, Pulcini Gabriele, Leonardi Elena, Raoul Pauline, Rinninella Emanuele, De Maio Flavio, Capristo Esmeralda, Gasbarrini Antonio, Mele Maria Cristina
UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Centro di Ricerca e Formazione in Nutrizione Umana, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Microorganisms. 2025 Jun 17;13(6):1410. doi: 10.3390/microorganisms13061410.
Lifestyle, diet, and genetics are established risk factors for developing colorectal cancer (CRC). In recent years, the role of the gut microbiota (GM) has been increasingly highlighted in several studies, suggesting an effect on both the disease's pathogenesis and the efficacy and tolerability of treatments. We conducted a search on Medline, aiming to identify published studies exploring the role of the GM in the development and treatment of CRC. Dysbiosis, an imbalance in GM, is common in CRC patients and is associated with precancerous lesions, aggressive tumors, and varied therapy outcomes. Restoring GM balance can reduce treatment complications and may improve prognosis. The review details how GM influences CRC through metabolite production, inflammation modulation, and immune response alteration. Diet significantly impacts GM composition, with processed meats and high-fat diets increasing CRC risk, while fiber-rich diets are protective. The role of the GM in CRC treatments like surgery, chemotherapy, radiotherapy, and immunotherapy is also explored, noting its influence on complications, chemoresistance, and treatment efficacy. Future strategies involving GM modulation through diet, probiotics, and fecal microbiota transplantation (FMT) show promise for CRC prevention and treatment, warranting further research.
生活方式、饮食和基因是罹患结直肠癌（CRC）的既定风险因素。近年来，肠道微生物群（GM）的作用在多项研究中得到了越来越多的强调，这表明其对该疾病的发病机制以及治疗的疗效和耐受性均有影响。我们在Medline上进行了检索，旨在找出已发表的探讨GM在CRC发生发展及治疗中作用的研究。生态失调，即GM失衡，在CRC患者中很常见，并且与癌前病变、侵袭性肿瘤以及多样的治疗结果相关。恢复GM平衡可减少治疗并发症，并可能改善预后。该综述详细阐述了GM如何通过代谢产物生成、炎症调节和免疫反应改变来影响CRC。饮食对GM组成有显著影响，加工肉类和高脂肪饮食会增加CRC风险，而富含纤维的饮食则具有保护作用。还探讨了GM在CRC手术、化疗、放疗和免疫治疗等治疗中的作用，指出其对并发症、化疗耐药性和治疗效果的影响。未来通过饮食、益生菌和粪便微生物群移植（FMT）调节GM的策略在CRC预防和治疗方面显示出前景，值得进一步研究。
