Introduction: The upper gastrointestinal microbiome is a dynamic entity that is involved in numerous processes including digestion, production of vitamins and protection against pathogens. Many external and intrinsic factors may cause changes in the proportions of bacteria within the microbial community, termed ‘dysbiosis’. A number of these have been identified as risk factors for a range of diseases, including oesophago-gastric carcinoma. Materials and Methods: A narrative review was conducted to elucidate the current evidence on the role of the microbiome in promoting oesophago-gastric tumourigenesis. Significant causes of dysbiosis including age, medications and GORD were examined and key pro-inflammatory pathways implicated in tumourigenesis and their interaction with the microbiome were described. Results and Discussion: An association between microbial dysbiosis and development of oesophago-gastric cancer may be mediated via activation of pro-inflammatory pathways, the inflammasome and the innate immune system. Advances in sequencing technology allow microbial communities to be fingerprinted by sequencing the 16S rRNA gene, enabling a deeper understanding of the genera that may be implicated in driving tumourigenesis. Conclusions: Developing a greater understanding of the influence of the microbiota on oesophago-gastric tumourigenesis may enable advances to be made in the early detection of malignancy and in the development of novel systemic therapies, leading to improved rates of survival.
引言：上消化道微生物组是一个动态实体，参与消化、维生素合成及病原体防御等多种生理过程。多种外源性和内源性因素可能导致微生物群落内细菌比例失衡，即"菌群失调"。其中部分因素已被确定为包括食管胃腺癌在内的多种疾病的风险因素。材料与方法：本文通过叙述性综述阐明微生物组在促进食管胃肿瘤发生中的作用机制。研究分析了年龄、药物及胃食管反流病等导致菌群失调的重要因素，并阐述了与肿瘤发生相关的关键促炎通路及其与微生物组的相互作用。结果与讨论：微生物菌群失调与食管胃癌发展的关联可能通过激活促炎通路、炎症小体和先天免疫系统介导。测序技术的进步使得通过16S rRNA基因测序实现微生物群落指纹识别成为可能，从而更深入地理解可能驱动肿瘤发生的菌属。结论：深化对微生物群影响食管胃肿瘤发生机制的理解，有望推动恶性肿瘤早期检测技术的进步及新型系统疗法的开发，最终提高患者生存率。
Altered Microbiome Promotes Pro-Inflammatory Pathways in Oesophago-Gastric Tumourigenesis
肿瘤(癌症)患者之家