Picking up microbial clues in early-onset colorectal cancer.
Picking up microbial clues in early-onset colorectal cancer.
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DOI：
10.1136/gutjnl-2022-328427
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发表时间：
2023-06
期刊：
影响因子：
24.5
通讯作者：
Dey, Neelendu
中科院分区：
文献类型：
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作者：
Dey, Neelendu
近年来，早发性结直肠癌（EO-CRC）发病率上升的认识在胃肠病学领域引起了冲击波。同样，名人受“平权”影响的案例震惊了更广泛的公众，并引起了人们对筛查重要性的关注。电视节目主持人凯蒂·库里克的丈夫在42岁时死于EO-CRC后，她在2000年接受了一次直播结肠镜检查，这导致结肠镜检查的筛查率显著增加，被称为“凯蒂·库里克效应”。最近，广受赞誉的演员查德威克·博斯曼（Chadwick Boseman）不幸死于eoc，享年43岁，这再次提高了人们对筛查必要性的认识和讨论。结肠镜检查是一种极好的筛查工具，但对低于推荐开始筛查年龄（世界许多地区的推荐年龄为50岁）的个体效用有限。虽然随着时间的推移，由于系统筛查，CRC的总体发病率逐渐下降，但在年轻人中，CRC的发病率却在惊人地上升。大约12%的crc被诊断为年龄小于50岁的个体，4促使美国最近将筛查建议转移到45岁。35开始筛查的门槛降低并不能完全解决EO-CRC问题，因为45岁以下人群的CRC发病率也在增加（例如，20-24岁人群的CRC发病率为每年6%），这一现象大约在10年前就开始了。事实上，上面提到的两个名人案例都是在45岁之前就患上了结直肠癌。从医疗成本的角度来看，充分降低结肠镜初次筛查的年龄以捕获所有EO-CRC病例是不太可行的：尽管发病率上升，但年轻人中CRC的总体发病率较低，因此，需要接受结肠镜检查以挽救一条生命的人数相对较高。我们需要额外的策略来有效地识别高危人群。新出现的数据表明，肠道微生物组和微生物产生的小分子代谢物作为结直肠癌的生物标志物，可能为新的基于粪便的筛查工具奠定基础。[9] kong等人10询问eo型结直肠癌患者的肠道微生物组和代谢组是否与年龄匹配的对照组不同，更重要的是，是否与晚年患结直肠癌的个体不同。他们招募了451名个体，包括迟发性CRC （LO-CRC；定义为≥50岁），EO-CRC（< 50岁）和每个CRC队列的对照组。利用霰弹枪测序和质谱数据集，他们确定了每个队列中细菌分类群、细菌基因和代谢物的富集或缺失。他们在EO-CRC和LO-CRC中观察到的CRC的一般特征包括CRC中α多样性的降低，与年龄匹配的对照组相比，全球微生物群落的差异，几种细菌的富集(例如Bacte-
The recognition that early-onset colorectal cancer (EO-CRC) rates are rising has sent shockwaves through the field of gastroenterology in recent years. Cases of celebrities affected by EO-CRC have similarly shocked the broader public and have drawn attention to the importance of screening. After television anchor Katie Couric’s husband died of EO-CRC at age 42, she underwent an on-air colonoscopy in 2000, which led to a significant increase in screening colonoscopy rates that was dubbed ‘the Katie Couric effect’. 1 More recently, the acclaimed actor Chadwick Boseman tragically died of EO-CRC at age 43, again increasing awareness and discussion of the need for screening. Colonoscopy is an excellent screening tool but of limited utility to individuals younger than the recommended age of initiation of screening, which is 50 in many parts of the world. 2 While overall CRC rates have progressively decreased over time due to systematic screening, CRC has alarmingly been on the rise in younger individuals. 3 Approximately 12% of CRCs are diagnosed in individuals younger than 50, 4 prompting a recent shift of screening recommendations in the USA to age 45. 3 5 This lowered threshold for initiating screening will not solve the problem of EO-CRC entirely, as CRC rates in individuals younger than 45 are also increasing (eg, at rates of> 6% per year among persons 20–24 years of age), a phenomenon which started approximately a decade ago. 6 Indeed, the two celebrity cases cited above involved individuals who developed CRC earlier than 45. From a healthcare costs perspective, it is unlikely to be feasible to sufficiently lower the age of initial screening colonoscopy to capture all EO-CRC cases: despite rising rates, the overall incidence of CRC in young people is low, and therefore, the number of individuals needing to undergo colonoscopy to save one life is relatively high. 7 We need additional strategies for effectively identifying highrisk individuals. Emerging data implicate the gut microbiome and microbiomegenerated small molecule metabolites as biomarkers of CRC that could potentially form the basis for novel stool-based screening tools. 8 9Kong et al 10 ask whether the gut microbiomes and metabolomes of EO-CRC patients differ from age-matched controls and, importantly, from individuals who develop CRC later in life. They recruited 451 individuals that included late-onset CRC (LO-CRC; defined as≥ 50 years of age), EO-CRC (< 50 years of age) and controls for each CRC cohort. Using shotgun sequencing and mass spectrometry datasets, they identified bacterial taxa, bacterial gene, and metabolites enriched or depleted in each cohort. Generalisable features of CRC that they observed in both EO-CRC and LO-CRC included reduced alpha diversity in CRC, global microbial community differences compared with age-matched controls, enrichment of several bacteria (eg, Bacte-
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综合宏基因组和代谢组分析揭示了早发性结直肠癌中独特的肠道微生物组衍生表型
影响因子：
24.5
作者：
Kong, Cheng;Liang, Lei;Ma, Yanlei
通讯作者：
Ma, Yanlei
粪便宏基因组的荟萃分析揭示了针对大肠癌的全球微生物特征。
影响因子：
82.9
作者：
Wirbel J;Pyl PT;Kartal E;Zych K;Kashani A;Milanese A;Fleck JS;Voigt AY;Palleja A;Ponnudurai R;Sunagawa S;Coelho LP;Schrotz-King P;Vogtmann E;Habermann N;Niméus E;Thomas AM;Manghi P;Gandini S;Serrano D;Mizutani S;Shiroma H;Shiba S;Shibata T;Yachida S;Yamada T;Waldron L;Naccarati A;Segata N;Sinha R;Ulrich CM;Brenner H;Arumugam M;Bork P;Zeller G
通讯作者：
Zeller G
影响因子：
4.3
作者：
Bénard F;Barkun AN;Martel M;von Renteln D
通讯作者：
von Renteln D
影响因子：
6.2
作者：
Shah, Rajesh R.;Millien, Valentine O.;Thrift, Aaron P.
通讯作者：
Thrift, Aaron P.
影响因子：
16.6
作者：
Wu Y;Murray GK;Byrne EM;Sidorenko J;Visscher PM;Wray NR
通讯作者：
Wray NR