《生命科学》 2026, 38(8): 1400-1415

微生态与胃肠肿瘤的研究现状与进展

谢茗旭 , 于 君^*

香港中文大学，李嘉诚健康科学研究所，消化疾病研究全国重点实验室，消化疾病研究所，内科及药物治 疗学系，香港特别行政区

摘　要：

胃肠道肿瘤高发态势严峻，其防治研究始终是医学领域的重点课题。传统研究认为，宿主遗传和表观遗传是胃肠肿瘤的主要致病诱因，但近年来的研究逐渐揭示了胃肠道微生态作为“环境因素”促进胃癌和结直肠癌的发生与发展。本综述系统回顾了我们团队在该领域的重要突破。在胃癌中，除了经典的致病菌幽门螺杆菌，咽峡炎链球菌被鉴定为首个新型促癌菌，能够直接驱动炎症与胃癌进展。在结直肠癌方面，厌氧消化链球菌和胃链球菌被确认是新型的肿瘤驱动菌，而嗜热链球菌和丁酸梭菌等抑癌菌通过分泌特异性代谢产物发挥抗肿瘤效应。同时，肠道菌群在肿瘤治疗中也发挥着重要作用，特定菌株能够增强结直肠癌免疫检查点抑制剂的治疗疗效，噬菌体靶向清除致病菌可有效逆转化疗耐药。深入理解微生态在胃肠肿瘤进展与精准防治中的核心作用，能为构建基于微生物群的个体化诊疗新范式提供关键支撑。

通讯作者：于 君 , Email:junyu@cuhk.edu.hk

Gut microbiome in gastrointestinal cancer

XIE Mingxu , YU Jun^*

Institute of Digestive Disease and The Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China

Abstract:

The high incidence of gastrointestinal tumors, including gastric and colorectal cancers, poses a significant global  health challenge, highlighting the urgent need for developing effective prevention and treatment strategies. In the past decades, research has primarily identified host genetics and epigenetic alterations as the main pathogenic factors driving  gastric and colorectal carcinogenesis. However, recent studies have increasingly highlighted the gastrointestinal microbiome as a crucial ″environmental factor″ that significantly contributes to the occurrence, development, and progression of these  malignancies through complex host-microbe interactions. In this review, we systematically explore the important breakthroughs from our work in understanding the role of gut microbiome in gastric and colorectal cancers. In gastric cancer, alongside the well-established pathogenic bacterium Helicobacter pylori, Streptococcus anginosus has emerged as the first novel oncogenic bacterium capable of directly driving gastric inflammation, mucosal atrophy, intestinal metaplasia, and  tumorigenesis, representing a new paradigm in gastric carcinogenesis beyond classical pathogens. In colorectal cancer,  Peptostreptococcus anaerobius and Peptostreptococcus stomatis have been confirmed as new tumor-driving pathogens that  promote cellular proliferation and create favorable conditions for tumor growth, while beneficial bacteria such as  Streptococcus thermophilus and Clostridium butyricum exert potent anti-tumor effects through producing specific anti-cancer  metabolites and modulating host immune responses. Furthermore, certain beneficial strains demonstrate remarkable  therapeutic potential by enhancing the efficacy of immune checkpoint blockade therapy in colorectal cancer through immune microenvironment modulation. Conversely, eliminating specific pathogenic bacteria with targeted bacteriophage therapy effectively reverses chemotherapy resistance and restores drug sensitivity. Overall, our current understanding of the gut microbiome in gastrointestinal cancer has established a critical foundation for translating microbiota research into clinical practice, offering novel opportunities for precision medicine and ultimately benefiting patients.

Communication Author：YU Jun , Email:junyu@cuhk.edu.hk