作者：李晨曦1,2，李慕秋1，魏巍1，龚忠诚1，谭小容1，刘慧3，郑佞波4

Authors: Li Chenxi1,2, Li Muqiu1, Wei Wei1, Gong Zhongcheng1, Tan Xiaorong1, Liu Hui3, Zheng Ningbo4

Unit:  1. Department of Oral and Maxillofacial Oncology Surgery, the First Affiliated Hospital (Hospital of Stomatology) of Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi 830054, Xinjiang, China；  2. School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan 430022, Hubei, China；  3.Department of Oral and Maxillofacial Surgery, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai Key Laboratory of Craniomaxillofacial Development and Disease, Shanghai 200031, China；  4.Comprehensive Cancer Center, Wake Forest Baptist Health, Department of Microbiology & Immunology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA

摘要：

目的  口腔菌群与人类健康之间的关系已被学界广泛认识，本研究采用系统评价的方法总结分析牙龈卟啉单胞菌在消化系统恶性肿瘤中的作用。方法  检索PubMed、Embase、MEDLINE、Cochrane图书馆、Scopus和Web of Science数据库，检索时限均从建库至2023年8月25日。由2位评价员独立筛选文献、提取资料并评价纳入文献的偏倚风险。遵循系统评价和荟萃分析的首选报告项目（preferred reporting items for systematic reviews and Meta-analyses，PRISMA）方法对纳入文献进行系统评价，分析牙龈卟啉单胞菌在各消化道恶性肿瘤中的致癌机制。结果  共计28篇文献（包括2项前瞻性队列研究，26项病例对照研究）被纳入本次系统评价，包括胃癌、食管癌、结直肠癌、胰腺癌、肝癌等多种类型。其中研究食管癌的文献有5篇，胃癌有5篇，结直肠癌有9篇(其中1篇同时研究胃癌)，胰腺癌有7篇，肝癌有2篇。全部的纳入文献均报道了口腔菌群失调（包括牙龈卟啉单胞菌）与消化系统恶性肿瘤之间的风险关联。结论  本研究系统阐述了牙龈卟啉单胞菌在消化系统恶性肿瘤中的作用，对其可能的致病机制进行分析评价。

关键词： 牙龈卟啉单胞菌；消化系统恶性肿瘤；致病机制；系统评价

Abstract：

Objective  The association between oral bacteria and human health is widely recognized by the academic community. This study aimed to systematically review and analyze the role of Porphyromonas gingivalis (P.gingivalis) in malignant tumors of digestive system. Method  PubMed, EMbase, MEDLINE, Cochrane Library, Scopus and Web of Science databases were electronically retrieved and collected, from the inception to August 25th, 2023. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included literatures. Systematic review for the included literatures was performed in accordance with preferred reporting items for systematic reviews and Meta-analyses (PRISMA) protocol to investigate the carcinogenic mechanism of P.gingivalis in various gastrointestinal malignancies. Result  A total of twenty-eight literatures were eligible (2 prospective cohort studies and 26 case-controls), including the scoping on gastric cancer, esophageal cancer, colorectal cancer, pancreatic cancer, liver cancer and so on. Among them, there were 5 articles on esophageal cancer, 5 articles on gastric cancer, 9 articles on colorectal cancer (one of which studies was gastric cancer at the same time), 7 articles on pancreatic cancer, and 2 articles on liver cancer. In addition, all included articles reported the correlation of risk between oral dysbacteriosis (including P.gingivalis) and neoplasm of digestive system. Conclusion  In this study, the function of oral flora and its possible pathogenic mechanism in the digestive system malignancies are elucidated in a systematic and comprehensive way.

Key Words: Porphyromonas gingivalis; Malignant neoplasms of digestive system; Pathogenic mechanism; Systematic review