摘要

全球年轻低风险患者中晚期癌症的增加引发了对早发病例的研究。《自然》杂志一项研究指出，结直肠癌的激增与大肠杆菌产生的毒素colibactin有关，这一结论基于对981个肿瘤突变特征的分析。研究发现，超过半数40岁以下患者的损伤由colibactin引起，这些损伤可追溯至童年。研究还发现，colibactin产生菌较多的国家早发肠癌率较高，可能与抗生素使用、剖腹产及低纤维饮食有关。动物实验显示，低纤维饮食会损害结肠屏障，促进病原体定居。目前，针对大肠杆菌的治疗和噬菌体应用正在研究中，而筛查colibactin突变有望实现早期干预。进一步研究需明确因果关系并处理其他风险因素。

A global rise in advanced-stage cancers among young, low-risk patients has prompted investigations into early-onset cases. A study in Nature links colorectal cancer surges to colibactin, a toxin from E. coli strains, identified via mutational signatures in 981 tumors. Over 50% of under-40 patients exhibited colibactin damage, originating in early childhood. Researchers correlated higher colibactin-producing bacteria in countries with rising early-onset rates, potentially influenced by antibiotics, C-sections, and diets low in fiber. Animal studies suggest low-fiber diets weaken colon barriers, enabling pathogen colonization. While treatments targeting E. coli or using phages are under exploration, screening for colibactin mutations may enable early interventions. Further research is needed to confirm causality and address coexisting risk factors.