Эндоскопические критерии и перспективные биомаркеры зубчатых аденом ободочной кишки (обзор литературы)

Колоректальный рак (КРР) является одной из ведущих причин смертности от онкологических заболеваний во многих странах мира, как у мужчин, так и у женщин, и эти показатели имеют тенденцию к росту. Вероятность развития КРР составляет около 4–5 %, риск его развития связан с индивидуальными особенностями организма, вредными привычками, возрастом, хроническими заболеваниями и образом жизни, однако в большинстве случаев КРР развивается вследствие перерождения аденоматозных образований или по пути метаплазии из зубчатых аденом, его канцерогенезу содействуют иммунная дисрегуляция, дисбиоз и разрушение эпителия. Микробиота кишечника играет важную роль в канцерогенезе, вероятно, через механизм хронического воспаления. Некоторые из бактерий, ответственных за этот многофазный процесс, включают Fusobacterium spp., Bacteroides fragilis и энтеропатогенные Escherichia coli. кроме того, КРР вызывается мутациями, нацеленными на онкогены, гены – супрессоры опухолей и гены, связанные с механизмами репарации ДНК.

С учетом того, что среднее время развития аденокарциномы из предрака занимает около 10 лет, изменение кишечной микрофлоры может являться перспективным маркером для скрининга предраковых состояний толстой кишки, как и обнаружение изменений в ДНК.

В работе пойдет речь о взаимосвязи изменений микробного состава толстой кишки с выявленными путем молекулярно-генетического секвенирования генными мутациями.

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