Gut microbiota in esophageal cancer: mechanisms, clinical implications, and therapeutic potential
- 1College of Integrated Chinese and Western Medicine, Hebei Medical University
- 2Department of Medical Oncology, Gu'an County People's Hospital
- 3Department of Traditional Chinese Medicine, The Fourth Hospital of Hebei Medical University
Abstract
Esophageal cancer (EC) is a highly prevalent and aggressive gastrointestinal malignancy. Late diagnosis and heterogeneous responses to chemoradiotherapy and immune checkpoint inhibitor (ICI) therapies severely challenge clinical management. Accumulating evidence suggests that gut microbiota dysbiosis influences esophageal mucosal malignant transformation, tumor progression, and therapeutic outcomes through the gut-esophageal axis. However, most existing research remains correlational. To bridge this gap, this review critically synthesizes the dysbiosis signatures of EC and establishes a five-tier evidence grading framework to rigorously distinguish causal mechanisms from preclinical inferences. This microbial regulation is predominantly driven by metabolite-mediated signaling, remodeling of the tumor immune microenvironment (TME), intestinal barrier disruption, and oncogenic pathway activation. We functionally classify EC-associated dysbiosis into pro-tumorigenic, anti-tumorigenic, and context-dependent taxa, emphasizing a multidimensional ecosystem perspective. Furthermore, we evaluate the utility of gut microbial signatures as predictive biomarkers for neoadjuvant therapy and prognosis. Microbiota-targeted intervention strategies, including fecal microbiota transplantation (FMT), microecological preparations, and Traditional Chinese Medicine (TCM), have entered clinical exploration as adjunctive approaches to optimize treatment efficacy. Finally, we address current translational barriers and propose future directions, emphasizing multi-omics integration, spatial transcriptomics, and artificial intelligence (AI). This provides an objective, mechanistically grounded framework for advancing microbiota-guided personalized oncology in EC.
Related
- Natural products regulate gut microbiota and SCFA metabolism in IBD: mechanisms and therapeutic potential
- Crosstalk between gut microbiota-associated metabolites and adaptive immunity in cholecystitis: a conceptual mechanistic framework and potential therapeutic implications
- Gut microbiota- and probiotic-derived bioactive metabolites: mechanisms, evidence, and therapeutic potential in metabolic disorders
- Gut microbiota and intestinal permeability in rheumatoid arthritis: therapeutic implications and future directions
- Gut Microbiota-Host Redox Crosstalk: Molecular Mechanisms, Disease Pathogenesis, and Therapeutic Interventions.
BibTeX
@article{li2026microbiota,
title = {{Gut microbiota in esophageal cancer: mechanisms, clinical implications, and therapeutic potential}},
author = {Yonghao Li and Lu Zhou and Ruixue Huang and Yu Wang and Haibin Zhao and Meijuan Sun and Yushuang Zhang and Zhongbing Wu and Jing Li},
journal = {Frontiers in Microbiology},
year = {2026},
month = oct,
doi = {10.3389/fmicb.2026.1955627},
url = {https://www.frontiersin.org/articles/10.3389/fmicb.2026.1955627/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Gut microbiota in esophageal cancer: mechanisms, clinical implications, and therapeutic potential
AU - Yonghao Li
AU - Lu Zhou
AU - Ruixue Huang
AU - Yu Wang
AU - Haibin Zhao
AU - Meijuan Sun
AU - Yushuang Zhang
AU - Zhongbing Wu
AU - Jing Li
PY - 2026
DA - 2026/10/05
JO - Frontiers in Microbiology
DO - 10.3389/fmicb.2026.1955627
UR - https://www.frontiersin.org/articles/10.3389/fmicb.2026.1955627/full
AB - Esophageal cancer (EC) is a highly prevalent and aggressive gastrointestinal malignancy. Late diagnosis and heterogeneous responses to chemoradiotherapy and immune checkpoint inhibitor (ICI) therapies severely challenge clinical management. Accumulating evidence suggests that gut microbiota dysbiosis influences esophageal mucosal malignant transformation, tumor progression, and therapeutic outcomes through the gut-esophageal axis. However, most existing research remains correlational. To bridge this gap, this review critically synthesizes the dysbiosis signatures of EC and establishes a five-tier evidence grading framework to rigorously distinguish causal mechanisms from preclinical inferences. This microbial regulation is predominantly driven by metabolite-mediated signaling, remodeling of the tumor immune microenvironment (TME), intestinal barrier disruption, and oncogenic pathway activation. We functionally classify EC-associated dysbiosis into pro-tumorigenic, anti-tumorigenic, and context-dependent taxa, emphasizing a multidimensional ecosystem perspective. Furthermore, we evaluate the utility of gut microbial signatures as predictive biomarkers for neoadjuvant therapy and prognosis. Microbiota-targeted intervention strategies, including fecal microbiota transplantation (FMT), microecological preparations, and Traditional Chinese Medicine (TCM), have entered clinical exploration as adjunctive approaches to optimize treatment efficacy. Finally, we address current translational barriers and propose future directions, emphasizing multi-omics integration, spatial transcriptomics, and artificial intelligence (AI). This provides an objective, mechanistically grounded framework for advancing microbiota-guided personalized oncology in EC.
SN - 1664-302X
ER -