Introductions: cancer of unknown primary site (CUP) is a heterogeneous group of cancers in which metastases are found, and the primary tumor is not detected with available diagnostic methods. CUP is a disease that has not been fully researched, and its biology is unclear. The clinical characteristics of CUP are variable, but the prognosis of patients is usually unfavorable, and the possibilities of radical treatment are limited. The microbiome is the genes and gene products of microorganisms residing in a human body. In recent years, thanks to the use of next-generation sequencing, it is possible to assess the impact of the microbiome on human body functions. Head and neck cancers, due to the rich microbiome of this area, are influenced by it, and dysbiosis may be a risk factor for the development of cancer. Objective of this work: the aim of this study was to evaluate prognostic factors, clinical features including the microbiome, and treatment outcomes in patients with cancer of unknown primary site. Results: in the study group, increased numbers of bacteria of the phylaBacteroides,Fusobacteria,Bacillota,Actinomycetota,Actinobacteria, andCandidatuswere detected, whileFirmicutesandProteobacteriawere detected in smaller numbers. Independent predictors of CUP occurrence were the following: leukocyte count of at most 6.49 × 103/mm, bacteria from theProteobacteriaphylum in the microbiome below 11.6%,Firmicutesbelow 22.1%, andActinobacteriaat least 11.0%. Increased numbers ofPorphyromonasandFusobacteriumbacteria were associated with the risk of radiotherapy complications and shortened survival rate. Conclusions: clinical diagnosis and treatment of patients with CUP is complicated and difficult due to the lack of consensus on this issue. Treatment and prognosis of patients with CUP is unsatisfactory. The clinical value of the influence of the microbiome on the development, course, and treatment of cancer is becoming increasingly important. The microbiome may become a marker of response to anticancer treatment and the risk of its complications. Immunity modulation with the microbiome provides opportunities for further research on improving the effectiveness of oncological treatment.FusobacteriumandPorphyromonasseem to be the bacteria most important for the development of cancer, also worsening the prognosis of patients by increasing the risk of complications of radiotherapy and shortening the survival rate of patients.StreptococcusandLactobacillusseem to be bacteria that reduce the risk of cancer, reduce the risk of complications, and improve the prognosis of patients. Total protein deficiency and elevated inflammatory markers are also important predictors of cancer risk.
引言：原发灶不明癌症（CUP）是一组异质性恶性肿瘤，其特征是发现转移灶，但通过现有诊断方法未能检测到原发肿瘤。CUP是一种尚未被充分研究的疾病，其生物学机制尚不明确。该病的临床表现多样，但患者预后通常不佳，根治性治疗的可能性有限。微生物组是指寄居于人体内的微生物基因及其产物总和。近年来，得益于新一代测序技术的应用，评估微生物组对人体功能的影响成为可能。头颈部癌症因其所在区域微生物组丰富而受其影响，菌群失调可能是癌症发生的风险因素。本研究目的：旨在评估原发灶不明癌症患者的预后因素、临床特征（包括微生物组）及治疗结局。结果：在研究组中检测到拟杆菌门、梭杆菌门、芽孢杆菌门、放线菌门、放线菌纲及"Candidatus"类细菌数量增加，而厚壁菌门和变形菌门检出数量较少。CUP发生的独立预测因子包括：白细胞计数≤6.49×10³/mm³、微生物组中变形菌门细菌比例<11.6%、厚壁菌门<22.1%、放线菌纲≥11.0%。卟啉单胞菌属和梭杆菌属细菌数量增加与放疗并发症风险及生存率缩短相关。结论：由于缺乏共识，CUP患者的临床诊疗复杂且困难，其治疗与预后均不理想。微生物组对癌症发生、发展及治疗影响的临床价值日益凸显，可能成为抗癌治疗反应及并发症风险的生物标志物。通过微生物组进行免疫调节为提升肿瘤治疗效果的研究提供了新方向。梭杆菌属和卟啉单胞菌属似乎是影响癌症发生最重要的菌属，同时通过增加放疗并发症风险和缩短患者生存期而恶化预后。链球菌属和乳杆菌属则可能是降低癌症风险、减少并发症并改善预后的有益菌属。总蛋白缺乏和炎症标志物升高也是癌症风险的重要预测指标。
肿瘤(癌症)患者之家