人体微生态系统存在于胃肠道、口腔、泌尿生殖道、呼吸道和皮肤等多个部位，其中以肠道中的微生态系统最为主要和复杂。肠道微生态参与机体的生长发育、免疫调节、内分泌代谢等各种功能，并受到年龄、饮食、抗菌药物及心理压力、应激等因素的影响。肠道微生态的失调可能会引起许多疾病，包括皮肤病、肥胖、感染性疾病、心脑血管疾病和自身免疫病。随着肠道微生态与消化道疾病研究的不断深入，越来越多的学者发现，消化道肿瘤的发生、发展与肠道菌群失调有显著的相关性。肠道菌群失调通过微生物直接与肿瘤接触，调节机体免疫，产生细菌代谢物等机制直接或者间接作用影响肿瘤的发生、发展。此外，近年来研究还发现，肠道微生态与各类免疫检测点抑制剂如抗程序性死亡蛋白1抗体、抗程序性死亡蛋白配体1抗体及抗细胞毒性T淋巴细胞相关抗原4抗体的疗效密切相关，肠道微生态有可能是一个潜在的可预测肿瘤免疫治疗效果的生物标志物。本文归纳了肠道微生态的功能及其在消化道肿瘤发生、发展中的作用等，希望为今后的研究重点和发展方向提供参考。
Abstract
The human microecosystem exists in the gastrointestinal tract, oral cavity, urogenital tract, respiratory tract, skin, and other parts of bodies, which is the most important and complex in the intestine. Intestinal microecology is involved in the development of the body, immune regulation, endocrine metabolism and other functions, and also affected by age, diet, antibiotics, psychological pressure, stress and other factors. The imbalance of intestinal microecology may cause many diseases, including skin diseases, obesity, infectious diseases, cardiovascular and cerebrovascular diseases and autoimmune diseases. With the development of intestinal microecology and gastrointestinal diseases, more and more scholars have found that the development of gastrointestinal tumors are significantly related to intestinal flora imbalance. The imbalance of intestinal flora directly or indirectly affects the development of tumor through the direct contact between microorganism and tumor, the regulation of body immunity, the production of bacterial metabolites and other mechanisms. Additionally, recent studies showed that intestinal microecology is closely related to the efficacy of various immunosuppressive checkpoint inhibitors, such as anti-programmed cell death protein-1 antibody, anti-programmed cell death protein ligand-1 antibody and anti-cytotoxic T lymphocyte associated antigen-4 antibody, which may be a potential biomarker to predict the efficacy of tumor immunotherapy. The paper summarizes the function of intestinal microecology and its role in the development of gastrointestinal cancer, hoping to provide reference for the future research focus and development direction.
关键词
肠道微生态 /
胃癌 /
结直肠癌 /
肝癌 /
免疫治疗
Key words
Intestinal microecology /
Gastric cancer /
Rectal cancer /
Liver cancer /
Immunotherapy
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