Tumor Biology

, Volume 34, Issue 3, pp 1285–1300 | Cite as

The role of gut microbiota in the pathogenesis of colorectal cancer

  • Qingchao Zhu
  • Renyuan Gao
  • Wen Wu
  • Huanlong Qin


The human gastrointestinal tract harbors a complex and abundant microbial community that can reach levels as high as 1013–1014 microorganisms in the colon. These microorganisms are essential to a host’s well-being in terms of nutrition and mucosa immunity. However, numerous studies have also implicated members of the colonic microbiota in the development of colorectal cancer (CRC). While CRC involves a genetic component where damaged DNA and genetic instability initiates a malignant transformation, environmental factors can also contribute to the onset of CRC. Furthermore, considering the constant exposure of the colonic mucosa to the microbiome and/or its metabolites, the mucosa has long been proposed to contribute to colon tumorigenesis. However, the mechanistic details of these associations remain unknown. Fortunately, due to technical and conceptual advances, progress in characterizing the taxonomic composition, metabolic capacity, and immunomodulatory activity of human gut microbiota have been made, thereby elucidating its role in human health and disease. Furthermore, the use of experimental animal models and clinical/epidemiological studies of environmental etiological factors has identified a correlation between gut microbiota composition and gastrointestinal cancers. Bacteria continuously stimulate activated immunity in the gut mucosa and also contribute to the metabolism of bile and food components. However, the highest levels of carcinogen production are also associated with gut anaerobic bacteria and can be lowered with live lactobacilli supplements. In this review, evidence regarding the relationship between microbiota and the development of CRC will be discussed, as well as the role for microbial manipulation in affecting disease development.


Gut microbiota Colorectal cancer Inflammation Bacterial enzymes Metabolites Probiotic 



Colorectal cancer


Principle component analysis


Inflammatory bowel diseases


Transforming growth factor-β


Enterotoxigenic Bacteroides fragilis


Colonic epithelial cells


B. fragilis toxin


Pattern recognition receptors


Pathogen-associated molecular patterns


Toll-like receptors


Nod-like receptors


Nuclear factor κB




Single immunoglobulin IL-1 receptor-related molecule


Signal transducer and activator of transcription


Metabolite methylazoxymethanol


Deoxycholic acid


Lithocholic acid


Fecal bile acid


Prostaglandin E2


Nitroso compounds




Tumor necrosis factor-α


Colony-forming units




Reactive oxygen intermediate


Hydrogen sulfide



We thank Dr. Huanlong Qin for his critical reading of this manuscript.

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2013

Authors and Affiliations

  • Qingchao Zhu
    • 1
  • Renyuan Gao
    • 1
  • Wen Wu
    • 1
  • Huanlong Qin
    • 1
  1. 1.Department of SurgeryThe Sixth People’s Hospital Affiliated to Shanghai Jiao Tong UniversityShanghaiPeople’s Republic of China

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