Application of Fusobacterium nucleatum as a biomarker in gastrointestinal malignancies

Abstract

The morbidity and mortality of gastrointestinal (GI) malignancies are among the highest in the world, posing a serious threat to human health. Because of the insidious onset of the cancer, it is difficult for patients to be diagnosed at an early stage, and it rapidly progresses to an advanced stage, resulting in poor treatment and prognosis. Fusobacterium nucleatum (F. nucleatum) is a gram-negative, spore-free anaerobic bacterium that primarily colonizes the oral cavity and is implicated in the development of colorectal, esophageal, gastric, and pancreatic cancers via various intricate mechanisms. Recent development in novel research suggests that F. nucleatum may function as a biomarker in GI malignancies. Detecting the abundance of F. nucleatum in stool, saliva, and serum samples of patients may aid in the diagnosis, risk assessment, and prognosis monitoring of GI malignancies. This editorial systematically describes the biological roles and mechanisms of F. nucleatum in GI malignancies focusing on the application of F. nucleatum as a biomarker in the diagnosis and prognosis of GI malignancies to promote the clinical translation of F. nucleatum and GI tumors-related research.

Keywords: Biomarker; Diagnosis; Fusobacterium nucleatum; Gastrointestinal malignancies; Prognosis.

Figure 1

Underlying mechanism of Fusobacterium nucleatum pathogenesis in gastrointestinal malignancies. Fusobacterium nucleatum (F. nucleatum) adheres to and invades tumor cells through adhesins FadA on its surface, releasing virulence factors that promote the progression of gastrointestinal malignancies. Binding of F. nucleatum to receptors on the surface of tumor cells promotes the malignant transformation of tumor cells through a variety of mechanisms, including the induction of DNA damage, modulation of the immune microenvironment of tumors, and regulation of non-coding RNA expression. GC cells: Gastric cancer cells; GI cancer cells: Gastrointestinal cancer cells; Fn-GCEx: Exosomes secreted by F. nucleatum-infected GC cells; TLR4: Toll-like receptor 4; Gal-GalNAc: D-galactos-β (1-3)-N-acetyl-D-galactosamine; ESCC cells: Esophageal squamous carcinoma cells; MDSCs: Myeloid suppressor cells; PBMCs: Peripheral blood mononuclear cells; PMNs: Polymorphonuclear cells; NK cell: Natural killer cell.