The Role of Gut Microbiome in Hepatocellular Carcinoma: A Systematic Review

Abstract

Gut microbiome dysbiosis is common in patients with chronic liver diseases such as hepatocellular carcinoma (HCC) and plays an essential role in developing, diagnosing, and treating HCC. The purpose of this systematic review, which was carried out following the Preferred Reporting Items for Systematic Review and Meta-analyses 2020 guidelines, is to determine the role of the gut microbiome in the pathogenesis, diagnosis, and treatment of HCC. We collected and reviewed articles, including clinical trials, literature reviews, case-control studies, cross-sectional studies, cohort studies, systematic reviews, and meta-analyses, published between May 30, 2013, and May 30, 2023. The databases used to collect these articles included PubMed, Cochrane Library, Google Scholar, and ScienceDirect. After applying appropriate filters, a total of 2,969 studies were identified. They were further screened and subjected to quality assessment tools which finally yielded 17 studies included in this systematic review. This systematic review provides information regarding the gut-liver axis and the relationship between gut microbiome dysbiosis and HCC.

Keywords: gastrointestinal microbiome; gut flora; gut microbiome; hepatocellular carcinoma (hcc); liver cancer.

Figure 1. PRISMA chart illustrating the screening process and quality assessment of the articles.

SANRA: Scale for the Quality Assessment of Narrative Review Articles; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; AXIS tool: Appraisal Tool for Cross-Sectional Studies