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Brit J Cancer:用于预测结直肠肿瘤风险的微生物标志物

2022-03-18 MedSci原创 MedSci原创

该综述提供了支持不同类型微生物物种之间关联的证据及其对结直肠肿瘤的预测价值的观点。从病例对照研究开发的预测模型需要在高质量的前瞻性研究中开展进一步的外部验证。

结直肠癌(CRC)是世界上第三大最常见的癌症,也是癌症死亡的第二大原因。据报道,与女性相比,男性患CRC的风险更高,女性患CRC死亡率的风险比男性低25%。先前的证据表明,这种性别特异性差异可能归因于对性激素的不同暴露,尤其是对雌激素的暴露不同相关。尽管已经进行了大量研究,但对CRC的复杂病因以及发病机制的全面了解仍然难以捉摸。越来越多的证据表明,肠道菌群失调可能与结直肠癌的发病机制有关,这可能导致慢性代谢和炎症变化,从而促进结直肠癌的发生。

大量证据表明肠道微生物群落的生态失调与结直肠肿瘤有关。近日,肿瘤学领域权威杂志British Journal of Cancer上发表了一篇研究文章,该综述旨在系统总结与结直肠肿瘤相关的微生物标志物并评估其预测性能。

研究人员对MEDLINE和EMBASE数据库进行了全面的文献检索,以确定符合条件的研究。研究人员纳入了探索微生物生物标志物与结直肠肿瘤之间关联的观察性研究。此外,研究人员还纳入了使用微生物标记构建模型来预测CRC和腺瘤的预测研究,并评估了纳入的观察性和预测性研究的偏倚风险。

该荟萃分析纳入了45项研究,以评估微生物标志物与结直肠肿瘤之间的关联。研究人员共发现九种粪便微生物群(即梭杆菌属、肠球菌属、卟啉单胞菌属、沙门氏菌属、假单胞菌属、消化链球菌属、放线菌属、双歧杆菌属和罗斯氏菌属)、两种口腔病原体(即齿状密螺旋体和中间普雷沃氏菌)和对溶食性链球菌亚种溶食性链球菌的血清抗体水平与结直肠肿瘤有关。30项研究报告了使用微生物标记的预测模型,其中83.3%的模型具有可接受的良好的区分度(AUROC>0.75)。预测性能的结局是有景的,但大多数研究仅限于少数病例(范围为9-485例)并且缺乏独立的外部验证(76.7%)。

由此可见,该综述提供了支持不同类型微生物物种之间关联的证据及其对结直肠肿瘤的预测价值的观点。从病例对照研究开发的预测模型需要在高质量的前瞻性研究中开展进一步的外部验证。未来研究应评估将微生物生物标志物纳入CRC筛查计划的可行性和影响。

原始出处:

Lili Yu.et al.A systematic review of microbial markers for risk prediction of colorectal neoplasia.Brit J Cancer.2022.https://www.nature.com/articles/s41416-022-01740-7

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