Esophageal cancer (EC) is one of the most common malignant tumors worldwide, and its two major types, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), present a severe global public health problem with an increasing incidence and mortality. Established risk factors include smoking, alcohol consumption, and dietary habits, but recent research has highlighted the substantial role of oral microbiota in EC pathogenesis. This review explores the intricate relationship between the microbiome and esophageal carcinogenesis, focusing on the following eight significant mechanisms: chronic inflammation, microbial dysbiosis, production of carcinogenic metabolites, direct interaction with epithelial cells, epigenetic modifications, interaction with gastroesophageal reflux disease (GERD), metabolic changes, and angiogenesis. Certain harmful bacteria, such asPorphyromonas gingivalisandFusobacterium nucleatum, are specifically implicated in sustaining irritation and tumor progression through pathways including NF-κB and NLRP3 inflammasome. Additionally, the review explores how microbial byproducts, including short-chain fatty acids (SCFAs) and reactive oxygen species (ROS), contribute to DNA harm and disease advancement. Furthermore, the impact of reflux on microbiota composition and its role in esophageal carcinogenesis is evaluated. By combining epidemiological data with mechanistic understanding, this review underscores the potential to target the microbiota–immune system interplay for novel therapeutic and diagnostic strategies to prevent and treat esophageal cancer.
食管癌是全球最常见的恶性肿瘤之一，其两大主要类型——食管腺癌与食管鳞状细胞癌——正随着发病率和死亡率的不断上升，成为严峻的全球公共卫生问题。已知风险因素包括吸烟、饮酒及饮食习惯，但近期研究揭示了口腔微生物群在食管癌发病机制中的重要作用。本文综述探讨了微生物群与食管癌发生之间的复杂关联，重点聚焦以下八种关键机制：慢性炎症、微生物菌群失调、致癌代谢物产生、与上皮细胞的直接相互作用、表观遗传修饰、与胃食管反流病的相互作用、代谢改变以及血管生成。特定有害细菌（如牙龈卟啉单胞菌和具核梭杆菌）通过激活NF-κB和NLRP3炎症小体等途径，持续刺激组织并促进肿瘤进展。此外，本文还探讨了微生物代谢产物（包括短链脂肪酸和活性氧）如何导致DNA损伤及疾病进展，并评估了胃食管反流对微生物组成的影响及其在食管癌发生中的作用。通过整合流行病学数据与机制研究，本综述强调了靶向微生物群-免疫系统相互作用在开发新型食管癌防治策略及诊断方法中的潜在价值。
Mechanistic Insights on Microbiota-Mediated Development and Progression of Esophageal Cancer
肿瘤(癌症)患者之家