Upper gastrointestinal tract microbiota with oral origin in relation to oesophageal squamous cell carcinoma

Abstract

Introduction: Poor oral hygiene is linked to high risks of many systemic diseases, including cancers. Oral dysbiosis is closely associated with poor oral hygiene, causing tooth loss, gingivitis, and periodontitis. We provide a summary of studies and discuss the risk factors for oesophageal squamous cell carcinoma (ESCC) from a microbial perspective in this review.Methods: A literature search of studies published before December 31, 2022 from PubMed, Web of Science, and The Cochrane Library was performed. The search strategies included the following keywords: (1) oral care, oral health, oral hygiene, dental health, dental hygiene, tooth loss, teeth loss, tooth absence, missing teeth, edentulism, tooth brushing, mouthwash, and tooth cleaning; (2) esophageal, esophagus, oesophagus, and oesophageal; (3) cancer, carcinoma, tumor, and neoplasm.Discussion: Poor oral health, indicated by infrequent tooth brushing, chronic periodontitis, and tooth loss, has been associated with an increased risk of squamous dysplasia and ESCC. Oral microbial diversity and composition are profoundly dysregulated during oesophageal tumorigenesis. Similar to the oral microbiota, the oesophageal microbiota varies distinctly in multiple bacterial taxa in ESCC and gastric cardia adenocarcinoma, both of which have high co-occurrence rates in the "Oesophageal Cancer Belt". In addition, the potential roles of oncogenic viruses in ESCC have also been discussed. We also briefly explore the potential mechanisms underlying the tumor-promoting role of dysregulated microbiota for the development of therapeutic targeting strategies.Conclusion: Poor oral health is an established risk indicator of ESCC. The dysbiosis of microbiota in upper gastrointestinal tract that highly resembles the oral microbial ecosystem but with distinct features at individual sites contributes to the development and progression of ESCC.

Keywords: Oesophageal squamous cell carcinoma; microbiota; periodontitis; porphyromonas gingivalis; tooth loss.

Figure 1.

Forest Plot for the associations between oesophageal squamous cell carcinoma risk and tooth loss, and poor oral hygiene. The diamonds indicate best estimate of the true (pooled) risk with width indicating 95% confidence intervals (CI). for details, see text.

Figure 2.

The distribution of previously published bacterial taxa derived from oral cavity and oesophagus that represented by the square and circle, respectively. The red/green indicates a detrimental and preventive bacterial taxa. For details, see text.

Figure 2.

The distribution of previously published bacterial taxa derived from oral cavity and oesophagus that represented by the square and circle, respectively. The red/green indicates a detrimental and preventive bacterial taxa. For details, see text.

Figure 2.

The distribution of previously published bacterial taxa derived from oral cavity and oesophagus that represented by the square and circle, respectively. The red/green indicates a detrimental and preventive bacterial taxa. For details, see text.