Emerging evidence highlights the crucial role of gastrointestinal microbiota in the pathogenesis of gastric cancer.Helicobacter pylori(H. pylori) infection stands out as a primary pathogenic factor. However, interventions such as anti-H. pyloritherapy, gastric surgeries, immunotherapy, and chronic inflammation significantly remodel the gastric microbiome, implicating a broader spectrum of microorganisms in cancer development. These microbial populations can modulate gastric carcinogenesis through various mechanisms, including sustained chronic inflammation, bacterial genotoxins, alterations in short-chain fatty acids, elevated gastrointestinal bile acids, impaired mucus barrier function, and increased concentrations of N-nitrosamines and lactic acid. The dynamic changes in gut microbiota also critically influence the outcomes of anti-cancer therapies by modifying drug bioavailability and metabolism, thus affecting therapeutic efficacy and side effect profiles. Additionally, the effectiveness of radiotherapy can be significantly impacted by gut microbiota alterations. Novel therapeutic strategies targeting the microbiome, such as dietary interventions, probiotic and synbiotic supplementation, and fecal microbiota transplantation, are showing promise in cancer treatment. Understanding the intricate relationship between the gut microbiota and gastric cancer is essential for developing new, evidence-based approaches to the prevention and treatment of this malignancy.
最新研究证据凸显了胃肠道菌群在胃癌发病机制中的关键作用。幽门螺杆菌感染作为主要致病因素已被广泛认知。然而，抗幽门螺杆菌治疗、胃部手术、免疫疗法及慢性炎症等干预措施会显著重塑胃部微生物组，提示更广泛的微生物谱系参与癌症发展进程。这些微生物群可通过多种机制调控胃癌发生发展，包括：持续慢性炎症反应、细菌基因毒素作用、短链脂肪酸代谢改变、胃肠道胆汁酸水平升高、黏液屏障功能受损以及N-亚硝胺和乳酸浓度增加。肠道菌群的动态变化还能通过改变药物生物利用度和代谢过程，显著影响抗癌治疗效果及副作用特征。此外，放疗疗效也会受到肠道菌群改变的重要影响。针对微生物组的新型治疗策略，如饮食干预、益生菌与合生元补充剂以及粪便微生物移植等，在癌症治疗中展现出广阔前景。深入理解肠道菌群与胃癌之间复杂的相互作用关系，对于制定基于循证医学的胃癌防治新策略具有重要意义。
肿瘤(癌症)患者之家