摘要
雄激素剥夺疗法是晚期前列腺癌的一线疗法。虽然雄激素剥夺治疗初期疗效确切,但治疗后出现的临床问题,不仅降低患者的生活质量,还将因其进展为去势抵抗性前列腺癌(CRPC),影响疗效,甚至危及健康或生命。肠道微生态与肠道局部疾病有关,也与肝脏、神经系统等多系统疾病息息相关,但其与前列腺癌之间的关联研究尚少。前列腺癌的雄激素剥夺疗法会影响前列腺癌患者的肠道微生态,从而诱导一些相关并发症的发生与CRPC的形成。本文分别从肠道微生态多样性、肠道菌群结构以及功能通路改变的角度,阐述前列腺癌雄激素剥夺疗法对肠道微生态产生的微生态影响,并提出相应对策,如粪便微生物移植、口服抗生素和益生菌等,以调节肠道微生态,改善前列腺癌雄激素剥夺疗法疗效与预期,为晚期前列腺癌的诊治提供新的思路。
Androgen deprivation therapy is widely regarded as the first-line therapy for advanced prostate cancer.Although the initial efficacy is significant,clinical complications that arise after the therapy can reduce the patient′s life quality,affect the efficacy,and even endanger their health or life due to the progression to castration-resistant prostate cancer(CRPC).The gut microbiota is associated not only with local diseases of the intestinal tract but also with systemic diseases such as liver or neurological diseases,but its relationship with prostate cancer is less frequently studied.Androgen deprivation therapy for prostate cancer affects the gut microbiota of prostate cancer patients,thereby inducing relevant complications and promoting CRPC formation.In this review,we present the microecological effects of androgen deprivation therapy for prostate cancer on gut microbiota from the perspectives of gut microbiota diversity,intestinal microbiota structure,and functional pathways.We also propose corresponding countermeasures,such as fecal microbiota transplantation,oral antibiotics,and oral probiotics,to improve the efficacy and outcome of androgen deprivation therapy for prostate cancer by regulating gut microbiota,and provide new ideas for the diagnosis and treatment of advanced prostate cancer.
作者
刘嘉仪
朱依萍
韩邦旻
夏术阶
Liu Jiayi;Zhu Yiping;Han Bangmin;Xia Shujie(Shanghai Jiao Tong University Institute of Urology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200080,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2023年第2期84-88,共5页
National Medical Journal of China
关键词
前列腺癌
雄激素剥夺疗法
肠道微生态
Prostatic cancer
Androgen deprivation therapy
Intestinal microbiome
