Sindaco Maria, Mercanti Leonardo, Puca Valentina, Mazzone Mariangela, Di Marcantonio Maria Carmela, Muraro Raffaella, Fiordaliso Michele, Mincione Gabriella
Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Department of Pharmacy, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
Front Oncol. 2025 Jun 26;15:1519277. doi: 10.3389/fonc.2025.1519277. eCollection 2025.
Pancreatic Ductal Adenocarcinoma (PDAC) is currently a major oncological threat given the very low 5-year survival rates of 8-9%. The tumor itself is intertwined with its surrounding tissue in a peculiar tumoral microenvironment (TME) which contributes to resistance against the host immune system and traditional clinical treatments, such as chemotherapy. One of the components of TME is the microbiota, which mainly includes the bacterial species identified in the tumor tissue at various stages. Current literature highlights an active role of the microbiota in tumorigenesis, progression, metastasis, and chemotherapy response in PDAC patients. This review gathered the most recent findings about microbial composition in PDAC patients, along with the effects of intra and extra-tumoral (GI and oral) microbial species on the TME and immune system, their role in tumor progression and immuno-modulation. This paper provides an insight on the potential use of microbes as diagnostic and prognostic markers, and as an additional therapeutic strategy. The study of microbiota offer new ways to slow down carcinogenesis, modulate the immune response, and even serve as an early diagnostic tool in the absence of specific serum markers. In the current review we will offer an inquiry on these potential roles. We sorted out the most recent literature with a comprehensive and critical approach, sourcing papers from PubMed. We exclusively opted for papers that were published in the last 5 years on journals with IF≥4, with a focus on the impact of intra-tumoral microbiome on the natural history of PDAC, from pre-tumoral lesions to metastasis.
胰腺导管腺癌（PDAC）目前是一种主要的肿瘤威胁，因为其5年生存率极低，仅为8%-9%。肿瘤本身在特殊的肿瘤微环境（TME）中与其周围组织相互交织，这导致了对宿主免疫系统和传统临床治疗（如化疗）的抗性。TME的组成部分之一是微生物群，其主要包括在肿瘤组织不同阶段鉴定出的细菌种类。当前文献强调了微生物群在PDAC患者的肿瘤发生、进展、转移和化疗反应中的积极作用。本综述收集了关于PDAC患者微生物组成的最新发现，以及肿瘤内和肿瘤外（胃肠道和口腔）微生物种类对TME和免疫系统的影响、它们在肿瘤进展和免疫调节中的作用。本文深入探讨了微生物作为诊断和预后标志物以及作为一种额外治疗策略的潜在用途。微生物群的研究提供了减缓致癌作用、调节免疫反应的新方法，甚至在缺乏特定血清标志物的情况下可作为早期诊断工具。在当前综述中，我们将探讨这些潜在作用。我们采用全面且批判性的方法梳理了最新文献，从PubMed获取论文。我们专门选择了过去5年内在影响因子≥4的期刊上发表的论文，重点关注肿瘤内微生物群对PDAC自然病程（从肿瘤前病变到转移）的影响。
