The landscape of gut microbiota in hepatocarcinogenesis: a comprehensive review of pathogenesis and therapeutic interventions.
- 2025-09-22
- International journal of surgery (London, England) 112(1)
- Zhi-Bo Yan
- Cheng-Long Han
- Ji-Sen Jia
- Han Li
- Dong-Hai Lu
- Qi-Hang Cao
- Yu-Xuan Wang
- Ke-Fan Jiao
- Qiao He
- Sheng-Xuan Peng
- Dao-Lin Zhang
- Qiang Wang
- Tao Li
- PubMed: 40990659
- DOI: 10.1097/js9.0000000000003511
Study Design
- Type
- Review
Primary liver cancer (PLC) represents a significant global health burden, with hepatocellular carcinoma (HCC) being its predominant subtype. The gut microbiota plays a crucial role in the pathogenesis, treatment, and postoperative recovery of HCC through its regulatory functions along the gut-liver axis. This review systematically elucidates the role of gut microbiota dysbiosis and associated metabolites in the pathogenesis of HCC, specifically addressing the underlying mechanisms whereby gut microbiota and their metabolites mediate hepatic metabolic reprogramming, remodel the immune microenvironment, and promote HCC progression through crosstalk with intratumoral bacteria. It further explores the impact of the gut microbiota on immunotherapy, molecular targeted therapy, conventional chemotherapy, and surgical outcomes. Additionally, the review comprehensively outlines therapeutic strategies targeting the gut microbiota, including oral probiotics, antibiotics, fecal microbiota transplantation (FMT), particular small molecules, and traditional Chinese medicine. In summary, this review provides a comprehensive overview of how the gut microbiota influences the development and treatment of HCC and offers a theoretical foundation for targeting the microbiota to improve surgical prognosis in HCC patients.