肿瘤微环境中微生物的研究进展

大量研究已证明肠道微生物对肿瘤生物学有着多种影响, 已成为肿瘤发生和对癌症治疗反应的生物标志物和调节剂。然而, 目前对疾病相关微生物的了解很大程度上仅限于肠道微生物。近年来, 肿瘤组织中微生物的研究正处于快速发展阶段, 新的证据表明, 肿瘤内微生物群是肿瘤微环境的重要组成部分。肿瘤微环境中微生物群可能直接调节癌症的发生, 进展和对化学或免疫疗法的反应。这些发现不仅为肿瘤生物学提供了新的机制见解, 而且未来还可能成为肿瘤预防和治疗的新方向。本综述的目的主要是讨论肿瘤微环境中微生物在肿瘤发生发展、诊断和治疗中的作用。     

胃肠道微生物与胰腺癌研究进展

近年来,关于微生物在胰腺癌中的作用的研究逐渐增多,细菌和真菌与胰腺癌联系密切。既往通常认为胰腺是无菌器官,但是近些年研究表明胰腺中存在微生物群。细菌可能从肠道迁移到胰腺中。改变微生物群组成可能对胰腺癌治疗有积极作用。本文针对胃肠道微生物群落与胰腺癌之间的关系进行综述。     

胆囊切除术后患者肠道微生物群改变的研究进展

目的 总结胆囊切除术后肠道微生物群的变化、变化机制及与胆囊切除术后结直肠癌、非酒精性脂肪性肝脏疾病和胆囊切除术后综合征的关系,以期为胆囊切除术患者的围术期管理提供新思路。方法 检索国内外有关胆囊切除术后肠道微生物群相关的研究并进行综述。结果 胆囊切除术破坏了患者的肝脏-胆汁酸-肠道菌群轴,患者肠道微生物群的组成及多样性发生改变,这种改变可能导致结直肠癌、非酒精性脂肪性肝脏疾病、胆囊切除术后综合征等的发生,但具体机制仍不清楚。结论 胆囊切除术后肠道微生态的平衡被打破,胆囊切除术与肠道微生物群的关系可能为胆囊切除术患者围术期的管理、胆囊切除术后疾病或症状的预防及治疗提供新思路,但胆囊切除术对肠道微生物群的影响以及与疾病或症状的关系仍需进一步研究。     

从骨免疫学到骨微生物学：肠道微生物如何调节骨骼

肠道微生物群被称为人体的第二个基因库,在维持人体平衡中起主要作用。不良饮食习惯、抗生素滥用、病理状态和生活环境改变会对肠道菌群产生负面影响,以引起多种疾病。最新研究发现肠道微生物群与骨质疏松症之间有着密切的联系,同时引入了一个新术语"骨微生物学",该研究领域旨在弥合骨骼生理学、胃肠病学、免疫学和微生物学之间的差距。本文简要介绍了肠道菌群通过免疫系统、新陈代谢和内分泌环境以及其他因素影响骨代谢的潜在机制,通过研究肠道菌群与骨骼健康之间的关系,不仅对于维持骨骼健康和最大程度地减少骨质疏松症很重要,而且对于肠道微生物群是否可作为骨质疏松症新型治疗靶标以及是否可用作骨折预测的生物标志物方面具有重要意义。     

“第六届亚太肝胆胰学术大会”焦点荟萃及点评

由亚太肝胆胰协会(A-PHPBA)主办的"第六届亚太肝胆胰学术大会"于6月7日-10日在日本横滨举行。环亚太地区上千位国际知名学者共襄盛会。会议分别从临床和基础的角度探讨了肝胆胰疾病诊疗方面的最新成果。其中,尤以肝胆胰恶性肿瘤的微创治疗、新辅助治疗以及肝脏移植领域的新进展格外引人关注。     

混合现实技术在肝胆胰领域中的应用进展

目的 了解混合现实（mixed reality,MR）技术在肝胆胰领域中的应用进展，以期为MR技术融入肝胆胰学科发展提供借鉴。方法 对近年来国内外关于MR技术在肝胆胰领域应用的相关文献进行综述。结果 MR技术已广泛应用于肝胆胰领域的术前诊断评估及手术方案的制定、医患沟通、术中导航精准手术、教学实践等诸多方面，具有缩短手术时间、降低手术难度和提高手术成功率的优势，在一定程度上推动了肝胆胰领域临床诊疗方式的创新。结论 MR相关技术的应用发展对于肝胆胰外科手术及教学有着重要意义。随着MR技术和现代医学的发展进步，MR技术必将在智能化实时导航肝胆胰手术系统方面充分发挥优势，推动肝胆胰领域的精准治疗进一步发展。     

肠道细菌在结直肠癌发生发展中的作用研究进展

结直肠癌(CRC)是全球癌症相关死亡的第四大原因,是一种多因素的疾病,涉及遗传、环境和生活方式等风险因素.此外,越来越多的证据证实了肠道微生物群在结直肠癌的发生发展中的作用.已有研究证明肠道内细菌具有促炎和促癌的特性,这可能导致结直肠癌的发生.笔者将总结肠道微生物群与结直肠癌之间的潜在联系,重点是细菌微生物群的致癌特性...     

肠道微生物对骨骼质量的双向调节作用

人体肠道内的细菌、真菌、病毒、古细菌等共计1000余种微生物共同构成了人体肠道微生物群。肠道微生物在人类黏膜屏障功能、免疫功能、内分泌功能、消化及能量代谢的调节过程中发挥着重要作用。近几年研究发现肠道微生物也能调节骨骼代谢过程。肠道微生物影响骨骼质量的方式主要包括促进炎性因子的表达以刺激破骨细胞生成、作用于内分泌轴调控成骨细胞和破骨细胞活化水平、释放酸性代谢产物形成有利于钙离子吸收肠道环境。另外,肠道微生物还参与调控雌激素水平下降引起的骨丢失过程。可见肠道微生物对骨骼质量的调节作用是双向的,笔者将对此进行简要概述。     

老年人肌少症与肠道微生物群关联性研究进展

通过对肠道微生物群与肌少症的关系、危险因素及干预措施进行综述,指出医护人员应关注肌少症患者肠道微生物群情况,对共同危险因素进行早期干预,并积极探讨运动、营养及联合干预方案,以延缓肌肉萎缩,改善功能障碍和肠道微生物群落丰富度。     

胃肠道恶性肿瘤患者应用重组人生长激素后免疫功能的变化

为探讨重组人生长激素对胃肠道恶性肿瘤患者免疫功能的影响,对１２例胃肠道恶性肿瘤患者手术前,后及使用重组人生长激素后外周血Ｔ淋 细胞亚群和血清可溶性白介素－２受体进行了检测,并于１８例未使用ｒｈＧＨ的骨肠道恶性肿瘤患者及２０例健康人进行比较。结果：（１）胃肠道恶性肿瘤患者Ｔ淋巴细胞亚群中ＣＤ＾＋３,ＣＤ＾＋４细胞减少,ＣＤ＾＋４／ＣＤ＾＋９细胞比值下降,ｓＩＬ－２Ｒ水平升高;（２）手术切除肿瘤后,Ｃ     

Malrotation of the Intestine in Adult and Colorectal Cancer

Malrotation of the gut is a congenital anomaly and usually presents in childhood. Rarely, it may present in adults. Patients may be asymptomatic, and malrotation is detected during investigations, operation or autopsy. It can cause longstanding abdominal symptoms like pain, dyspepsia or acute abdomen due to volvulus. In adults, malrotation is found with different gastrointestinal malignancies like gastric, hepatobiliary, pancreatic and, in particular, colorectal neoplasms. We are reporting a case of 60-year-old female presented with carcinoma caecum along with malrotation of the gut. It is the first case report from India. We also reviewed documented cases of malrotation associated with colorectal malignancies. A large number of cases have been reported in Japan as compared to rest of the world. Malrotation in adults is probably associated with gastrointestinal malignancies. Possible causes of this association can be genetic factors or gut changes like chronic inflammation. These associations need further study to consider intestinal malrotation as premalignant lesion which may be very important in follow-up of children with malrotation.     

Positron emission tomography in hepatobiliary and pancreatic malignancies: a review

BackgroundThe prognosis for hepatobiliary and pancreatic malignancies is dismal. Surgery remains the primary curative option, but unresectable disease is often discovered during operative exploration. Positron emission tomography (PET) provides unique biological information different from current imaging modalities. The role of PET in detecting hepatobiliary and pancreatic malignancies has not yet been established. The purpose of this article was to review the literature on the use of PET in hepatobiliary and pancreatic malignancies.Data SourcesWe performed an extensive search on PubMed using PET and hepatocellular, pancreatic, gallbladder, and cholangiocarcinoma as keywords, excluding articles not written in English or on nonhuman subjects, case reports, and series with <5 patients.ConclusionsAlthough PET has shown usefulness in the diagnosis of certain cancers, current literature cautions against the use of PET for determining malignant potential of primary liver and pancreatic lesions. Literature on PET more strongly supports clinical roles for restaging of hepatobiliary and pancreatic malignancies, and for identifying metastatic disease.     

Gut Microbiota Regulate Pancreatic Growth,Exocrine Function,and Gut Hormones

Growing evidence indicates an important link between gut microbiota, obesity, and metabolic syndrome. Alterations in exocrine pancreatic function are also widely present in patients with diabetes and obesity. To examine this interaction, C57BL/6J mice were fed a chow diet, a high-fat diet (HFD), or an HFD plus oral vancomycin or metronidazole to modify the gut microbiome. HFD alone leads to a 40% increase in pancreas weight, decreased glucagon-like peptide 1 and peptide YY levels, and increased glucose-dependent insulinotropic peptide in the plasma. Quantitative proteomics identified 138 host proteins in fecal samples of these mice, of which 32 were significantly changed by the HFD. The most significant of these were the pancreatic enzymes. These changes in amylase and elastase were reversed by antibiotic treatment. These alterations could be reproduced by transferring gut microbiota from donor C57BL/6J mice to germ-free mice. By contrast, antibiotics had no effect on pancreatic size or exocrine function in C57BL/6J mice fed the chow diet. Further, 1 week vancomycin administration significantly increased amylase and elastase levels in obese men with prediabetes. Thus, the alterations in gut microbiota in obesity can alter pancreatic growth, exocrine function, and gut endocrine function and may contribute to the alterations observed in patients with obesity and diabetes.     

The Microbiome and Genitourinary Cancer: A Collaborative Review

ContextThe recent discovery of the existence of a human genitourinary microbiome has led to the investigation of its role in mediating the pathogenesis of genitourinary malignancies, including bladder, kidney, and prostate cancers. Furthermore, although it is largely recognized that members of the gastrointestinal microbiota are actively involved in drug metabolism, new studies demonstrate additional roles and the potential necessity of the gastrointestinal microbiota in dictating cancer treatment response.ObjectiveTo summarize the current evidence of a mechanistic role for the genitourinary and gastrointestinal microbiome in genitourinary cancer initiation and treatment response.Evidence acquisitionWe conducted a literature search up to October 2018. Search terms included microbiome, microbiota, urinary microbiome, bladder cancer, urothelial carcinoma, renal cell carcinoma, kidney cancer, testicular cancer, and prostate cancer.Evidence synthesisThere is preliminary evidence to implicate the members of the genitourinary microbiota as causative factors or cofactors in genitourinary malignancy. Likewise, the current evidence for gastrointestinal microbes in dictating cancer treatment response is mainly correlative; however, we provide examples where therapeutic agents used for the treatment of genitourinary cancers are affected by the human-associated microbiota, or vice versa. Clinical trials, such as fecal microbiota transplant to increase the efficacy of immunotherapy, are currently underway.ConclusionsThe role of the microbiome in genitourinary cancer is an emerging field that merits further studies. Translating microbiome research into clinical action will require incorporation of microbiome surveillance into ongoing and future clinical trials as well as expansion of studies to include metagenomic sequencing and metabolomics.Patient summaryThis review covers recent evidence that microbial populations that reside in the genitourinary tract—and were previously not known to exist—may influence the development of genitourinary malignancies including bladder, kidney, and prostate cancers. Furthermore, microbial populations that exist at sites outside of the genitourinary tract, such as those that reside in our gut, may influence cancer development and/or treatment response.     

Gut microbiome and bone

The gut microbiome is now viewed as a tissue that interacts bidirectionally with the gastrointestinal, immune, endocrine and nervous systems, affecting the cellular responses in numerous organs. Evidence is accumulating of gut microbiome involvement in a growing number of pathophysiological processes, many of which are linked to inflammatory responses. More specifically, data acquired over the last decade point to effects of the gut microbiome on bone mass regulation and on the development of bone diseases (such as osteoporosis) and of inflammatory joint diseases characterized by bone loss. Mice lacking a gut microbiome have bone mass alteration that can be reversed by gut recolonization. Changes in the gut microbiome composition have been reported in mice with estrogen-deficiency osteoporosis and have also been found in a few studies in humans. Probiotic therapy decreases bone loss in estrogen-deficient animals. The effect of the gut microbiome on bone tissue involves complex mechanisms including modulation of CD4⁺T cell activation, control of osteoclastogenic cytokine production and modifications in hormone levels. This complexity may contribute to explain the discrepancies observed betwwen some studies whose results vary depending on the age, gender, genetic background and treatment duration. Further elucidation of the mechanisms involved is needed. However, the available data hold promise that gut microbiome manipulation may prove of interest in the management of bone diseases.     

Gastrectomy impact on the gut microbiome in patients with gastric cancer: A comprehensive review

Gastric cancer is one of the most common malignancies worldwide and gastrectomy remains the only potentially curative treatment option for this disease. However, the surgery leads to significant physiological and anatomical changes in the gastrointestinal (GI) tract including loss of the gastric barrier, an increase in oxygenation levels in the distal gut, and biliary diversion after gastrectomy. These changes in the GI tract influence the composition of the gut microbiome and thus, host health. Gastrectomy-induced dysbiosis is characterized by increased abundance of typical oral cavity bacteria, an increase in aero-tolerant bacteria (aerobes/facultative anaerobes), and increased abundance of bile acid-transforming bacteria. Furthermore, this dysbiosis is linked to intestinal inflammation, small intestinal bacterial overgrowth, various GI symptoms, and an increased risk of colorectal cancer.     

Staging-laparoscopy

Summary. The so-called extended diagnostic laparoscopy (EDL) facilitates the comprehensive exploration of the abdominal cavity, thus improving the precision of the pretherapeutic tumor staging in gastrointestinal malignancies. EDL comprises visual inspection with a specific preparation of all relevant sites, laparoscopic sonography and retrieval of samples for biopsy and cytology. Additional relevant therapeutic information was obtained through EDL in 40.5 % of gastric cancer patients. EDL could be of similar importance for diagnosing esophageal, hepatobiliary and pancreatic malignancies.      

循环肿瘤DNA在胰腺癌中的临床应用进展

胰腺癌作为世界上最致命的恶性肿瘤之一,预后极差.由于缺乏特定症状,发病隐匿且发展迅速,导致大部分患者被诊断时已经处于为晚期,从而丧失有利的治疗时机.目前临床上患者多数通过影像学检查、生化检查和组织活检等方式综合诊断胰腺癌,但各有缺陷.随着近年来对肿瘤机制研究的不断深入以及液体活检技术的不断发展,循环肿瘤DNA(ctDN...     

Links Between the Microbiome and Bone

The human microbiome has been shown to influence a number of chronic conditions associated with impaired bone mass and bone quality, including obesity, diabetes, and inflammatory bowel disease. The connection between the microbiome and bone health, however, has not been well studied. The few studies available demonstrate that the microbiome can have a large effect on bone remodeling and bone mass. The gut microbiome is the largest reservoir of microbial organisms in the body and consists of more than a thousand different species interacting with one another in a stable, dynamic equilibrium. How the microbiome can affect organs distant from the gut is not well understood but is believed to occur through regulation of nutrition, regulation of the immune system, and/or translocation of bacterial products across the gut endothelial barrier. Here we review each of these mechanisms and discuss their potential effect on bone remodeling and bone mass. We discuss how preclinical studies of bone‐microbiome interactions are challenging because the microbiome is sensitive to genetic background, housing environment, and vendor source. Additionally, although the microbiome exhibits a robust response to external stimuli, it rapidly returns to its original steady state after a disturbance, making it difficult to sustain controlled changes in the microbiome over time periods required to detect alterations in bone remodeling, mass, or structure. Despite these challenges, an understanding of the mechanisms by which the gut microbiome affects bone has the potential to provide insights into the dissociation between fracture risk and bone mineral density in patients including those with obesity, diabetes, or inflammatory bowel disease. In addition, alteration of the gut microbiome has the potential to serve as a biomarker of bone metabolic activity as well as a target for therapies to improve bone structure and quality using pharmaceutical agents or pre‐ or probiotics. © 2016 American Society for Bone and Mineral Research.     

Effect of bacterial contamination in bile on pancreatic cancer cell survival

BackgroundIntroduction of gut ?ora into the biliary system is common owing to biliary stenting in patients with obstructing pancreatic head cancer. We hypothesize that alteration of biliary microbiome modi?es bile content that modulates pancreatic cancer cell survival.MethodsHuman bile samples were collected during pancreaticoduodenectomy. Bacterial strains were isolated from contaminated (stented) bile and identi?ed using 16S ribosomal RNA sequencing. Human pancreatic cancer cells (AsPC1, CFPAC, Panc1) were treated for 24 hours with sterile (nonstented) bile, contaminated (stented) bile, and sterile bile preincubated with 10⁶ colony forming unit of live bacteria isolated from contaminated bile or a panel of bile acids for 24 hours at 37°C, and evaluated using CellTiter-Blue Cell Viability Assay (Promega Corp. Madison, WI). Human bile (30–50 μl/mouse) was coinjected intraperitoneally with 10⁵ Panc02 mouse pancreatic cancer cells in C57BL6/N mice to evaluate the impact of bile on peritoneal metastasis 3 to 4 weeks after tumor challenge.ResultsWhile all bile samples signi?cantly reduced peritoneal metastasis of Panc02 cells in mice, some contaminated bile samples had diminished antitumor effect. All sterile bile (n = 4) reduced pancreatic cancer cell survival in vitro. Only 40% (2/5) of contaminated bile samples had significant effect. Preincubation of sterile bile with live Enterococcus faecalis or Streptococcus oralis modified the antitumor effect of sterile bile. These changes were not observed with culture media preincubated with live bacteria, suggesting live gut bacteria can modify the antitumor components present in bile. Conjugated bile acids were more potent than unconjugated cholic acid in reducing pancreatic cancer cell survival.ConclusionAlteration of bile microbiome from biliary stenting has a direct impact on pancreatic cancer cell survival. Further study is warranted to determine if this microbiome shift alters tumor microenvironment.