MECHANISTIC APPROACH OF ESOPHAGEAL CANCER DUE TO MICROBIAL GROWTH

Abstract

One of the main subtypes of esophageal cancer (EC), esophageal adenocarcinoma (EAC) is a developing worldwide health issue. The incidence of EAC has been continuously increasing in spite of gains in survival rates. Although genetic factors to EAC have been extensively studied, little is known about the involvement of the human microbiome in its pathophysiology. Recent research indicates a link between changes in the microbial ecology and the advancement of EAC, with particular bacterial genera acting as possible early detection indicators. Gastroesophageal reflux disease (GERD) is a significant risk factor for EAC because it causes long-term inflammation and molecular alterations that result in Barrett’s esophagus, a condition that precedes EAC. Long-term exposure to acid and bile causes Barrett’s esophagus, which in turn causes cellular change via pathways involving DNA damage, oxidative stress, and resistance to apoptosis. Important genetic changes, including modifications to COX- 2, p53, and cell cycle regulators, are linked to the transition from Barrett’s esophagus to EAC.Depending on the stage of the disease, endoscopic resection, chemotherapy, radiation therapy, targeted therapy, and immunotherapy are among the current treatment options for EAC. Although surgical procedures and proton pump inhibitors (PPIs) are used to treat GERD symptoms, their ability to stop the spread of malignancy is still up for discussion. Furthermore, innovative approaches to managing EAC risk include dietary changes, biomarkers for early identification, and developing treatment techniques including microbiota modification. Clarifying the molecular processes behind GERD-induced carcinogenesis, improving biomarker-based diagnostic methods, and creating treatments that target the microbiota should be the main goals of future research. Improving early detection, prevention, and individualized treatment plans requires an understanding of the complex interactions of genetic, microbial, and environmental variables in the course of EAC.

DOI - https://doi.org/10.65525/SVUP.9788198800473.2025.63-77