Human gut microbiota play an essential role in both healthy and diseased states of humans. In the past decade, the interactions between microorganisms and tumors have attracted much attention in the efforts to understand various features of the complex microbial communities, as well as the possible mechanisms through which the microbiota are involved in cancer prevention, carcinogenesis, and anti-cancer therapy. A large number of studies have indicated that microbial dysbiosis contributes to cancer susceptibility via multiple pathways. Further studies have suggested that the microbiota and their associated metabolites are not only closely related to carcinogenesis by inducing inflammation and immune dysregulation, which lead to genetic instability, but also interfere with the pharmacodynamics of anticancer agents. In this article, we mainly reviewed the influence of gut microbiota on cancers in the gastrointestinal (GI) tract (including esophageal, gastric, colorectal, liver, and pancreatic cancers) and the regulation of microbiota by diet, prebiotics, probiotics, synbiotics, antibiotics, or the Traditional Chinese Medicine. We also proposed some new strategies in the prevention and treatment of GI cancers that could be explored in the future. We hope that this review could provide a comprehensive overview of the studies on the interactions between the gut microbiota and GI cancers, which are likely to yield translational opportunities to reduce cancer morbidity and mortality by improving prevention, diagnosis, and treatment.
肠道微生物与人体健康和多种疾病密切相关，这是近年来全世界科学家们研究的焦点之一。各种高通量测序和组学研究产生的大数据使得研究者们日益深入、广泛、精准地了解人体微生物与不同疾病的相关性及其机制。本文着重回顾总结了肠道微生物与胃肠道肿瘤的致癌和抑癌相关性基础研究和临床转化研究。该领域大量研究证实，人体的肠道微生物生态环境错综复杂，一方面，肠道微生物失调参与了慢性炎症反应、免疫失调、基因的不稳定性形成等过程，对于增强肿瘤易感性起到重要作用；另一方面，调控肠道微生物在肿瘤预防及治疗中可以发挥其独特的积极作用。本文所涉及的胃肠道肿瘤包括食管癌、胃癌、大肠癌、肝癌、胆管癌及胰腺癌等，所采用的文献内容涵括了肠道微生物在健康人群、癌前病变、各种胃肠道肿瘤中的特点；肠道微生物参与肿瘤性疾病发生发展的可能机制的探讨，参与肿瘤预防、肿瘤化疗、靶向治疗、免疫治疗等方面的探索性基础研究和临床观察性研究；并归纳总结了应用食物、肠道益生菌、益生元、抗生素以及中药等调控肠道菌群等相关研究。人体微生物与人类息息相关，监测人体微生物组，预测人体健康和疾病状态，调控肠道微生物推动关于肿瘤预防、诊断和治疗领域的新策略形成，从而实现以“预见性、预防性、个体化及参与性医学模式”之理念指导和推动微生物研究，进一步降低肿瘤发病率和致死率。





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