Minireviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2023; 15(3): 443-463
Published online Mar 15, 2023. doi: 10.4251/wjgo.v15.i3.443
Genetic heterogeneity of colorectal cancer and the microbiome
Marina A Senchukova
Marina A Senchukova, Department of Oncology, Orenburg State Medical University, Orenburg 460000, Russia
Author contributions: Senchukova MA solely contributed to this paper.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marina A Senchukova, MD, PhD, Professor, Department of Oncology, Orenburg State Medical University, Sovetskaya Street, 6, Orenburg 460000, Russia. masenchukova@yandex.com
Received: November 10, 2022
Peer-review started: November 10, 2022
First decision: December 14, 2022
Revised: January 6, 2023
Accepted: February 22, 2023
Article in press: February 22, 2023
Published online: March 15, 2023
Processing time: 124 Days and 11.1 Hours
Abstract

In 2020, the International Agency for Research on Cancer and the World Health Organization's GLOBOCAN database ranked colorectal cancer (CRC) as the third most common cancer in the world. Most cases of CRC (> 95%) are sporadic and develop from colorectal polyps that can progress to intramucosal carcinoma and CRC. Increasing evidence is accumulating that the gut microbiota can play a key role in the initiation and progression of CRC, as well as in the treatment of CRC, acting as an important metabolic and immunological regulator. Factors that may determine the microbiota role in CRC carcinogenesis include inflammation, changes in intestinal stem cell function, impact of bacterial metabolites on gut mucosa, accumulation of genetic mutations and other factors. In this review, I discuss the major mechanisms of the development of sporadic CRC, provide detailed characteristics of the bacteria that are most often associated with CRC, and analyze the role of the microbiome and microbial metabolites in inflammation initiation, activation of proliferative activity in intestinal epithelial and stem cells, and the development of genetic and epigenetic changes in CRC. I consider long-term studies in this direction to be very important, as they open up new opportunities for the treatment and prevention of CRC.

Keywords: Gut microbiota; Bacterial metabolites; Colorectal cancer; Colorectal polyp; Stem cells; Epigenetic changes

Core Tip: Most cases of colorectal cancer (CRC) develop from colorectal polyps that can progress to intramucosal carcinoma and CRC. A large number of studies have indicated that the gut microbiota may play a key role in the initiation and progression of CRC. The mini-review discusses current ideas about the role of the microbiome and microbial metabolites in inflammation initiation, activation of proliferative activity in intestinal epithelial and stem cells and development of genetic and epigenetic changes in CRC. Further research in this direction is of great interest since these studies may contribute to the development of new CRC prevention and treatment methods.