肠道菌群在抗肿瘤支持治疗中的研究进展

Research progress on gut microbiota in antitumor supportive therapy

肠道微生物群(gut microbiota,GM)由数以万亿计的细菌、真菌、古细菌、寄生虫和病毒等组成,GM在机体内部和个体之间的组成因人而异,与饮食习惯、种族、宿主遗传、年龄和既往药物使用情况相关,并参与代谢、炎症、免疫和肿瘤等病理生理功能。GM作为肿瘤潜在生物标志物的作用及其对癌症支持治疗的安全性、耐受性和疗效具有重要临床意义。GM和癌症的关系复杂而密切,可作为生物标记物、诊断工具、治疗靶点,是癌症精准治疗中不可或缺的因素。其不仅对结直肠癌、胃癌等消化道肿瘤具有调节、诊断预测作用,也能在其他系统的恶性肿瘤如肺癌起到生物标志物作用;提高GM的多样性,减少抗生素的使用,降低有害菌群的丰度能有效提高肿瘤的预后、抗肿瘤治疗的疗效。本文旨在对GM在恶性肿瘤发生发展、放化疗的疗效和不良反应、免疫治疗的疗效与不良反应以及饮食通过GM对肿瘤的影响进行总结,为GM的精准化调控和检测对未来肿瘤治疗、肿瘤预测提供参考方向。

Gut microbiota(GM)are composed of trillions of bacteria,fungi,archaea,parasites,and viruses.The composition of GM varies among individuals;is related to habits,race,genetics,age,and previous drug use;and participates in physiological functions such as metabolism,inflammation,immunity,and tumor suppression.The potential role of GM as a tumor biomarker is clinically significant for the safety,tolerability,and efficacy of supportive cancer therapy.The relationship between GM and cancer is complex and close.GM can be used as a biomarker,diagnostic tool,or therapeutic target.GM are indispensable in the direct treatment of cancer and can regulate,diagnose,and prognosticate gastrointestinal tumors,including colorectal cancer and gastric cancer,and may also act as a biomarker for malignant tumors of other organ systems such as lung cancer.Improving the diversity of GM,reducing antibiotic use,and decreasing the abundance of harmful GM may effectively improve the prognosis of tumors and the efficacy of antitumor therapies.The study aimed to summarize the role of GM in the prevalence and development of malignant tumors;the efficacy and side effects of radiotherapy,chemotherapy,and immunotherapy;and the effect of diet(and subsequently GM)on tumors in order to lay the foundation for future research into the accurate regulation and detection of GM in both the treatment and prognostication of tumors.