收稿日期: 2022-03-02
录用日期: 2022-06-14
网络出版日期: 2022-07-26
基金资助
国家自然科学基金(81973078)
Role of gut microbiota in hepatocellular carcinoma: cancer occurrence, progresses and treatments
Received date: 2022-03-02
Accepted date: 2022-06-14
Online published: 2022-07-26
Supported by
National Natural Science Foundation of China(81973078)
人体内存在众多的微生物群落，肠道菌群在人体微生物库中的占比高达80%。肠道菌群通过参与新陈代谢、免疫稳态等生理过程来调节机体的消化和免疫功能，还可影响癌症的发生并控制机体对癌症治疗药物的反应。肝癌是典型炎癌转化的肿瘤类型，发展规律常遵循肝炎?肝纤维化?肝硬化?肝癌这一过程。肠道菌群与门脉系统、胆管系统组成的双向肠肝交流体系通常称为肠?肝轴，越来越多的研究证据表明肠道菌群能通过与肠?肝轴的交互循环作用参与肝癌发生发展的各个环节。鉴于在肝癌早期中的特异性变化，肠道菌群如今被视为肝癌早期诊断的新靶点。免疫治疗是针对中晚期肝癌的新兴治疗方式，通过益生菌、合理使用抗生素、粪便移植等方式调节肠道菌群可显著提高宿主的抗肿瘤免疫反应。在肝癌化疗、中药辅助、饮食模式等非免疫治疗的过程中，重塑肠道菌群稳态在延缓肿瘤进展、改善肝癌治疗预后效果及维持机体健康等方面具有重要的潜在价值。由于肠道菌群在肝癌的发生发展及治疗过程中发挥重要作用，因此该文综述了肠道菌群在肝炎?肝纤维化?肝硬化?肝癌过程中的相关研究，并论述了其作为肝癌预防、诊断及治疗靶点的巨大潜力。
卢雨 , 王昊 , 巴乾 . 肠道菌群在肝癌发生发展及治疗中的作用研究进展[J]. 上海交通大学学报（医学版）, 2022 , 42(7) : 939 -944 . DOI: 10.3969/j.issn.1674-8115.2022.07.014
The gut microbiota, as one of the microfloras existing in human body, is accounted for approximately 80% in human microbiome. Gut microbiota regulates digestive and immune functions through participating in physiological processes such as metabolism and immune homeostasis, meanwhile impacts the occurrence of cancer and controls the body response to cancer treatment drugs. Hepatocellular carcinoma (HCC) is a typical type of inflammatory cancer, the development of which follows the process of hepatitis, liver fibrosis, liver cirrhosis and HCC. The bidirectional communication system composed of gut microbiota, portal vein system and bile duct system, is usually called the enteric-liver axis. More and more research evidences show that gut microbiota can participate in the occurrence and development of HCC via the interaction cycle with the enteric-liver axis. In view of the specific transformation of gut microbiota in the early stage of HCC, it is usually regarded as a new target for the early diagnosis of HCC. Immunotherapy is an emerging treatment for advanced HCC. It is reported that regulating gut microbiota through probiotics, rational application of antibiotics, fecal transplantation and other methods can significantly improve the anti-tumor immune response of host. In the non-immunotherapy process of HCC chemotherapy, traditional Chinese medicine-assisted therapy and dietary pattern, remodeling gut microbiota homeostasis has potential value in postponing tumor progression, improving the prognosis of HCC treatment and maintaining body health. Since gut microbiota plays a crucial role in the occurrence, development and treatment of HCC, this review summarizes the studies of gut microbiota in the process of hepatitis, liver fibrosis, cirrhosis and HCC, and discusses its great potential as a target for the prevention, diagnosis and treatment of HCC.
Key words： gut microbiota; hepatocellular carcinoma; immunotherapy
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