Аннотация
В начале XXI в. сформировалась концепция «пародонтальной медицины», рассматривающая взаимосвязи патологии пародонта с системными заболеваниями организма. На текущий момент с патологией пародонта связано более 50 системных воспалительных заболеваний и сопутствующих заболеваний. Нами проведен поиск в информационных базах Pubmed и Scopus источников, опубликованных до 01.11.2024, в которых рассматривалась взаимосвязь патологии пародонта и онкологических заболеваний желудочно-кишечного тракта (ЖКТ). В рамках текущего обзора мы остановились на эпидемиологических аспектах связи заболеваний пародонта и рака ЖКТ, а также возможных механизмах выявленной взаимосвязи заболеваний пародонта и онкологических заболеваний ЖКТ. Большая часть найденных источников относится к последнему десятилетию, что свидетельствует об актуальности анализа связи заболеваний пародонта и онкологических заболеваний. Эпидемиологические исследования предполагают наличие положительной связи с общим риском рака и конкретными видами рака ЖКТ. Возможные механизмы связи заболеваний пародонта и рака предполагают транслокацию пародонтальных бактерий, прежде всего потенциальных канцерогенов Porphyromonas gingivalis и Fusobacterium nucleatum, гематогенным путем или по оси «рот–кишечник»/«рот–ЖКТ» с последующим развитием хронического воспаления и иммунных нарушений. Дальнейшее изучение взаимосвязи заболеваний пародонта и рака открывает новые перспективы в профилактике, диагностике и лечение онкологических заболеваний ЖКТ.
Ключевые слова: коморбидность, патология пародонта, пародонтит, рак полости рта, рак желудка, рак поджелудочной железы, колоректальный рак, Porphyromonas gingivalis, Fusobacterium nucleatum.
Об авторе
Д.И. Трухан, А.Ф. Сулимов, Л.Ю. Трухан, М.Ю. Рожкова
ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия dmitry_trukhan@mail.ru
Список литературы
1. Клинические рекомендации (протоколы лечения) при диагнозе пародонтит. URL: http://www.e-stomatology.ru/director/protokols_30-09-2014/ Clinical guidelines (treatment protocols) in the diagnosis of periodontitis. URL: http://www.e-stomatology.ru/director/protokols_30-09-2014 (in Russian).
2. Balta MG, Papathanasiou E, Blix IJ, Van Dyke TE. Host Modulation and Treatment of Periodontal Disease. J Dent Res 2021;100(8):798-809. DOI: 10.1177/0022034521995157.
3. O'Dwyer MC, Furgal A, Furst W et al. The Prevalence of Periodontitis Among US Adults with Multimorbidity Using NHANES Data 2011-2014. J Am Board Fam Med 2023;36(2):313-24. DOI: 10.3122/jabfm.2022.220207R1
4. Williams RC, Offenbacher S. Periodontal medicine: The emergence of a new branch of periodontology. Periodontology 2000;23:9-12 DOI: 10.1034/j.1600-0757.2000.2230101.x
5. Pai SI, Matheus HR, Guastaldi FPS. Effects of periodontitis on cancer outcomes in the era of immunotherapy. Lancet Healthy Longev 2023;4(4):e166-e175. DOI: 10.1016/S2666-7568(23)00021-1
6. Bizuayehu HM, Ahmed KY, Kibret GD et al. Global Disparities of Cancer and Its Projected Burden in 2050. JAMA Netw Open 2024;7(11):e2443198. DOI: 10.1001/jamanetworkopen.2024.43198
7. Baima G, Ribaldone DG, Romano F et al. The Gum-Gut Axis: Periodontitis and the Risk of Gastrointestinal Cancers. Cancers (Basel). 2023;15(18):4594. DOI: 10.3390/cancers15184594
8. Kaliamoorthy S, Priya Sayeeram S, Gowdhaman N et al. Association of Periodontal Red Complex Bacteria With the Incidence of Gastrointestinal Cancers: A Systematic Review and Meta-Analysis. Cureus 2024;16(4):e59251. DOI: 10.7759/cureus.59251
9. Zhang Y, Sun C, Song EJ et al. Is periodontitis a risk indicator for gastrointestinal cancers? A meta-analysis of cohort studies. J Clin Periodontol 2020;47(2):134-47. DOI: 10.1111/jcpe.13217
10. Madugula S, Dhamodhar D, Devdoss P et al. Oral dysbiosis and risk of gastrointestinal cancers: A systematic review and meta-analysis of longitudinal studies. Indian J Gastroenterol 2024;43(4):729-39. DOI: 10.1007/s12664-024-01546-w
11. Wang Q, Gu WJ, Ning FL et al. Association between Periodontal Diseases and the Risk of Site-Specific Gastrointestinal Cancers: A Systematic Review and Meta-Analysis. J Dent Res 2024;103(10):962-72. DOI: 10.1177/00220345241263768
12. Michaud DS, Fu Z, Shi J, Chung M. Periodontal Disease, Tooth Loss, and Cancer Risk. Epidemiol Rev 2017;39(1):49-58. DOI: 10.1093/epirev/mxx006
13. Corbella S, Veronesi P, Galimberti V et al. Is periodontitis a risk indicator for cancer? A meta-analysis. PLoS One 2018;13(4):e0195683. DOI: 10.1371/journal.pone.0195683
14. Kim EH, Nam S, Park CH et al. Periodontal disease and cancer risk: A nationwide population-based cohort study. Front Oncol 2022;12:901098. DOI: 10.3389/fonc.2022.901098
15. Higham J, Scannapieco FA. Epidemiological associations between periodontitis and cancer. Periodontol 2000;2024 Sep 20. DOI: 10.1111/prd.12599. Online ahead of print.
16. Villar A, Mendes B, Viègas M et al. The relationship between periodontal disease and cancer: Insights from a Systematic Literature Network Analysis. Cancer Epidemiol 2024;91:102595. DOI: 10.1016/j.canep.2024.102595
17. Wen BW, Tsai CS, Lin CL et al. Cancer risk among gingivitis and periodontitis patients: a nationwide cohort study. QJM 2014;107(4):283-90. DOI: 10.1093/qjmed/hct248
18. Yao QW, Zhou DS, Peng HJ et al. Association of periodontal disease with oral cancer: a meta-analysis. Tumour Biol 2014;35(7):7073-7. DOI: 10.1007/s13277-014-1951-8
19. Ye L, Jiang Y, Liu W, Tao H. Correlation between periodontal disease and oral cancer risk: A meta-analysis. J Cancer Res Ther 2016;12(Supplement):C237-C240. DOI: 10.4103/0973-1482.200746
20. Li R, Hou M, Yu L et al. Association between periodontal disease and oral squamous cell carcinoma: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2023;61(6):394-402. DOI: 10.1016/j.bjoms.2023.05.004
21. Ma Y, Tuerxun N, Maimaitili G. Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. Acta Odontol Scand 2024;83:40478. DOI: 10.2340/aos.v83.40478
22. Farhad SZ, Karbalaeihasanesfahani A, Dadgar E et al. Promising potential effects of resveratrol on oral and dental health maintenance: a comprehensive review. Naunyn Schmiedebergs Arch Pharmacol 2024;Sep 21. DOI: 10.1007/s00210-024-03457-1
23. Ciani L, Libonati A, Dri M et al. About a Possible Impact of Endodontic Infections by Fusobacterium nucleatum or Porphyromonas gingivalis on Oral Carcinogenesis: A Literature Overview. Int J Mol Sci 2024;25(10):5083. DOI: 10.3390/ijms25105083
24. He Z, Tian W, Wei Q, Xu J. Involvement of Fusobacterium nucleatum in malignancies except for colorectal cancer: A literature review. Front Immunol 2022;13:968649. DOI: 10.3389/fimmu.2022.968649
25. Ma Y, Yu Y, Yin Y et al. Potential role of epithelial-mesenchymal transition induced by periodontal pathogens in oral cancer. J Cell Mol Med 2024;28(1):e18064. DOI: 10.1111/jcmm.18064
26. Pignatelli P, Nuccio F, Piattelli A, Curia MC. The Role of Fusobacterium nucleatum in Oral and Colorectal Carcinogenesis. Microorganisms 2023;11(9):2358. DOI: 10.3390/microorganisms11092358 27. Akbari E, Epstein JB, Samim F. Unveiling the Hidden Links: Periodontal Disease, Fusobacterium Nucleatum, and Cancers. Curr Oncol Rep 2024. DOI: 10.1007/s11912-024-01591-w. Online ahead of print.
28. Li X, Kolltveit KM, Tronstad L, Olsen I. Systemic diseases caused by oral infection. Clin Microbiol Rev 2000;13:547-58. DOI: 10.1128/CMR.13.4.547
29. Liu F, Tang SJ, Li ZW et al. Poor oral health was associated with higher risk of gastric cancer: Evidence from 1431677 participants. World J Gastrointest Surg 2024;16(2):585-95. DOI: 10.4240/wjgs.v16.i2.585
30. Aguiar FJN, Menezes FDS, Fagundes MA et al. Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis. Clinics (Sao Paulo) 2024;79:100321. DOI: 10.1016/j.clinsp.2023.100321
31. Muñoz-Medel M, Pinto MP, Goralsky L et al. Porphyromonas gingivalis, a bridge between oral health and immune evasion in gastric cancer. Front Oncol 2024;14:1403089. DOI: 10.3389/fonc.2024.1403089 32. Mi S, Cai S, Lou G, Xue M. Two-sample Mendelian randomization analysis of the relationship between periodontitis and risk of upper gastrointestinal cancers. Postgrad Med J 2024;100(1189):820-6. DOI: 10.1093/postmj/qgae069
33. Lehr K, Nikitina D, Vilchez-Vargas R et al. Microbial composition of tumorous and adjacent gastric tissue is associated with prognosis of gastric cancer. Sci Rep 2023;13(1):4640. DOI: 10.1038/s41598-023-31740-3
34. Poorolajal J, Moradi L, Mohammadi Y et al. Risk factors for stomach cancer: a systematic review and meta-analysis. Epidemiol Health 2020;42:e2020004. DOI: 10.4178/epih.e2020004
35. Zhang L, Chen X, Ren B et al. Helicobacter pylori in the Oral Cavity: Current Evidence and Potential Survival Strategies. Int J Mol Sci 2022;23(21):13646. DOI: 10.3390/ijms232113646
36. López-Valverde N, Macedo de Sousa B, López-Valverde A et al. Possible Association of Periodontal Diseases With Helicobacter pylori Gastric Infection: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022;9:822194. DOI: 10.3389/fmed.2022.822194
37. Трухан Д.И., Сулимов А.Ф., Трухан Л.Ю. Коморбидность патологии пародонта и язвенной болезни. Клинический разбор в общей медицине. 2024;5(10):6-11. DOI: 10.47407/kr2024.5.10.00488 Trukhan D.I., Sulimov A.F., Trukhan L.Y. Comorbidity of periodontal pathology and peptic ulcer disease. Clinical review for general practice. 2024;5(10):6-11. DOI: 10.47407/kr2024.5.10.00488 (in Russian).
38. Payão SL, Rasmussen LT. Helicobacter pylori and its reservoirs: A correlation with the gastric infection. World J Gastrointest Pharmacol Ther 2016;7(1):126-32. DOI: 10.4292/wjgpt.v7.i1.126
39. Xie FJ, Zhang YP, Zheng QQ et al. Helicobacter pylori infection and esophageal cancer risk: an updated meta-analysis. World J Gastroenterol 2013;19(36):6098-107. DOI: 10.3748/wjg.v19.i36.6098
40. Guo Y, Liu W, Wu J. Helicobacter pylori infection and pancreatic cancer risk: A meta-analysis. J Cancer Res Ther 2016;12(Supplement):C229-C232. DOI: 10.4103/0973-1482.200744
41. Zuo Y, Jing Z, Bie M et al. Association between Helicobacter pylori infection and the risk of colorectal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2020;99(37):e21832. DOI: 10.1097/MD.0000000000021832
42. Трухан Д.И. Коморбидность заболеваний пародонта и неалкогольной жировой болезни печени. Экспериментальная и клиническая гастроэнтерология. 2024;223(3):14-24. DOI: 10.31146/1682-8658-ecg-223-3-14-24 Trukhan D.I. Comorbidity of periodontal diseases and non-alcoholic fatty liver disease. Experimental and Clinical Gastroenterology. 2024;223(3):14-24. DOI: 10.31146/1682-8658-ecg-223-3-14-24 (in Russian).
43. Jordão HW, McKenna G, McMenamin ÚC et al. The association between self-reported poor oral health and gastrointestinal cancer risk in the UK Biobank: A large prospective cohort study. United European Gastroenterol J 2019;7(9):1241-9. DOI: 10.1177/2050640619858043
44. Al-Maweri SA, Ibraheem WI, Al-Ak'hali MS et al. Association of periodontitis and tooth loss with liver cancer: A systematic review. Crit Rev Oncol Hematol 2021;159:103221. DOI: 10.1016/j.critrevonc.2021.103221 45. Chang JS, Tsai CR, Chen LT, Shan YS. Investigating the Association Between Periodontal Disease and Risk of Pancreatic Cancer. Pancreas 2016;45(1):134-41. DOI: 10.1097/MPA.0000000000000419
46. Maisonneuve P, Amar S, Lowenfels AB. Periodontal disease, edentulism, and pancreatic cancer: a meta-analysis. Ann Oncol 2017;28(5):985-95. DOI: 10.1093/annonc/mdx019
47. Xu S, Wang HL, Xia C et al. Associations Between Poor Oral Hygiene and Risk of Pancreatic Cancer: A Meta-analysis of Observational Studies. Pancreas 2022;51(8):985-94. DOI: 10.1097/MPA.0000000000002143
48. Bracci PM. Oral Health and the Oral Microbiome in Pancreatic Cancer: An Overview of Epidemiological Studies. Cancer J 2017;23(6):310-4. DOI: 10.1097/PPO.0000000000000287
49. Márquez-Arrico CF, Silvestre FJ, Marquez-Arrico JE, Silvestre-Rangil J. Could Periodontitis Increase the Risk of Suffering from Pancreatic Cancer? A Systematic Review. Cancers (Basel) 2024;16(7):1257. DOI: 10.3390/cancers16071257
50. Трухан Д.И., Сулимов А.Ф., Трухан Л.Ю. Коморбидность воспалительных заболеваний кишечника и патологии пародонта. Медицинский совет. 2024;18(15):62-70. DOI: 10.21518/ms2024-373 Trukhan D.I., Sulimov A.F., Trukhan L.Yu. Comorbidity of inflammatory bowel diseases and periodontal pathology. Meditsinskiy Sovet. 2024;18(15):62-70. DOI: 10.21518/ms2024-373 (in Russian).
51. Тарасова Л.В., Трухан Д.И. Болезни кишечника. Клиника, диагностика и лечение. СПб.: СпецЛит; 2022. URL: https://elibrary.ru/ item.asp?id=49497776 Tarasova L.V., Trukhan D.I. Intestinal diseases. Clinic, diagnosis and treatment. St. Petersburg: SpecLit, 2022. URL: https://elibrary.ru/item.asp?id=49497776 (in Russian).
52. Hu JM, Shen CJ, Chou YC et al. Risk of colorectal cancer in patients with periodontal disease severity: a nationwide, population-based cohort study. Int J Colorectal Dis 2018;33(3):349-52. DOI: 10.1007/s00384-018-2965-2
53. Li W, Xu J, Zhang R et al. Is periodontal disease a risk indicator for colorectal cancer? A systematic review and meta-analysis. J Clin Periodontol 2021;48(3):336-47. DOI: 10.1111/jcpe.13402
54. Xuan K, Jha AR, Zhao T et al. Is periodontal disease associated with increased risk of colorectal cancer? A meta-analysis. Int J Dent Hyg 2021;19(1):50-61. DOI: 10.1111/idh.12483
55. Yamaoka Y, Suehiro Y, Hashimoto S et al. Fusobacterium nucleatum as a prognostic marker of colorectal cancer in a Japanese population. J Gastroenterol 2018;53(4):517-24. DOI: 10.1007/s00535-017-1382-6
56. Wang N, Fang JY. Fusobacterium nucleatum, a key pathogenic factor and microbial biomarker for colorectal cancer. Trends Microbiol 2023;31(2):159-72. DOI: 10.1016/j.tim.2022.08.010
57. Li YY, Ge QX, Cao J et al. Association of Fusobacterium nucleatum infection with colorectal cancer in Chinese patients. World J Gastroenterol 2016;22(11):3227-33. DOI: 10.3748/wjg.v22.i11.3227
58. Nosho K, Sukawa Y, Adachi Y et al. Association of Fusobacterium nucleatum with immunity and molecular alterations in colorectal cancer. World J Gastroenterol 2016;22(2):557-66. DOI: 10.3748/wjg.v22.i2.557
59. Hashemi Goradel N, Heidarzadeh S, Jahangiri S et al. Fusobacterium nucleatum and colorectal cancer: A mechanistic overview. J Cell Physiol 2019;234(3):2337-44. DOI: 10.1002/jcp.27250
60. Mesa F, Mesa-López MJ, Egea-Valenzuela J et al. A New Comorbidity in Periodontitis: Fusobacterium nucleatum and Colorectal Cancer. Medicina (Kaunas) 2022;58(4):546. DOI: 10.3390/medicina58040546
61. Villar-Ortega P, Expósito-Ruiz M, Gutiérrez-Soto M et al. The association between Fusobacterium nucleatum and cancer colorectal: A systematic review and meta-analysis. Enferm Infecc Microbiol Clin (Engl Ed) 2022;40(5):224-34. DOI: 10.1016/j.eimce.2022.02.007
62. Datorre JG, de Carvalho AC, Guimarães DP, Reis RM. The Role of Fusobacterium nucleatum in Colorectal Carcinogenesis. Pathobiology 2021;88(2):127-40. DOI: 10.1159/000512175
63. Takeda M, Doki Y. The Power of the Gut Microbiome: Exploring New Perspectives in Colorectal Cancer Therapy. Gan To Kagaku Ryoho 2024;51(6):608-12. URL: https://pubmed.ncbi.nlm.nih.gov/39009515/
64. Baima G, Minoli M, Michaud DS et al. Periodontitis and risk of cancer: Mechanistic evidence. Periodontol 2000 2023;Dec 15. DOI: 10.1111/prd.12540
65. Nwizu N, Wactawski-Wende J, Genco RJ. Periodontal disease and cancer: Epidemiologic studies and possible mechanisms. Periodontol 2000 2020;83(1):213-33. DOI: 10.1111/prd.12329
66. Tuominen H, Rautava J. Oral Microbiota and Cancer Development. Pathobiology 2021;88(2):116-26. DOI: 10.1159/000510979
Для цитирования: Трухан Д.И., Сулимов А.Ф., Трухан Л.Ю., Рожкова М.Ю. Коморбидность заболеваний пародонта и рака желудочно-кишечного тракта. Клинический разбор в общей медицине. 2025; 6 (6): 34–39. DOI: 10.47407/kr2025.6.6.00628
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