THE ROLE OF MICROBIOLOGICAL INFECTIONS IN THE ETIOLOGY OF COLORECTAL CANCER
Palavras-chave:adenocarcinoma, colorectal neoplasms, sexually transmitted diseases
Colorectal cancer (CRC) is a disease that affects part of the gastrointestinal tract. The risk for developing CRC can be inherited, but as the disease is multifactorial, it is believed that environmental factors play a more important role than heredity. Thus, it was identified that CRC is also associated with infections by pathogens, especially with sexually transmitted infections. The aim of this study is to describe the pathophysiology of CRC, as well as to assess whether infections caused by Human Papillomavirus (HPV), Human Immunodeficiency Virus (HIV) and Neisseria gonorrhoeae are capable of promoting alterations that may lead to colorectal carcinogenesis. This is an integrative review of studies collected on PubMed, ScienceDirect and LILACS platforms; using the descriptors ''Adenocarcinoma'', "Alphapapillomavirus", "Colorectal Neoplasms" "Gonorrhea", "HIV" and "Sexually Transmitted Diseases". We included 32 studies, in English and Portuguese, available in full. Based on the analyses, it was observed that most RCCs originate from polyps that evolve into adenomas. This process occurs as a result of distinct and cumulative alterations, especially in oncogenes, tumor suppressor genes and repair genes. After the research, it was found that HPV infection is a potential risk factor for CRC, since the virus is capable of promoting enough alterations to cause its carcinogenesis. In addition, our analyzes do not rule out that HIV carriers are also a high-risk group for the onset of the disease, and one of the hypotheses for this event is the action of the Tat oncoprotein. In gonorrhea, it was demonstrated that colitis – a common manifestation of the disease, can evolve from a controllable clinical condition to the development of CRC, due to a pathological response of inflammasomes. Therefore, it is believed that our conclusions may have an important scientific significance for a better understanding of the risk factors associated with CRC.
BENSON, A. B. B. Epidemiology, disease progression, and economic burden of colorectal cancer. J Manag
Care Pharm, v. 13, n. 6, p. 5-18, ago./2007.
BERRETTA, et al. Clinical Presentation and Outcome of Colorectal Cancer in HIV-Positive Patients: A Clinical Case-Control Study. KARGER, v. 32, n. 1, p. 319-324, mai./2020.
BINI; GREEN; POLES. Screening colonoscopy for the detection of neoplastic lesions in asymptomatic HIVinfected subjects. British Society of Gastroenterology, v. 58, n. 1, p. 1129-1134, mar./2009.
BINI; PARK; FRANCOIS. Use of Flexible Sigmoidoscopy to Screen for Colorectal Cancer in HIV-Infected
Patients 50 Years of Age and Older. ARCH INTERN MED, v. 166, n. 1, p. 1626-1631, nov./2006.
BRAVO, I. G.; FÉLEZ-SÁNCHEZ, M. Papillomaviruses: Viral evolution, cancer and evolutionary medicine. for
Evolution, Medicine, and Public Health, v., n. 1, p. 32-51, jan./2015.
BUYRU, Nur; TEZOL, Ayda; DALAY, Nejat. Coexistence of K-ras mutations and HPV infection in colon cancer. BMC Cancer, v. 6, n. 115, p. 1-5, mai./2006.
CHEN, T. et al. Human papilloma virus 16 E6 oncoprotein associated with p53 inactivation in colorectal
cancer. World Journal of Gastroenterology, v. 18, n. 30, p. 4051-4058, ago./2012.
CONLIN, A. et al. The prognostic significance of K-ras, p53, and APC mutations in colorectal carcinoma.
Gut, v. 54, n. 9, p. 1283-1286, sep./2005.
DIENSTMANN, R. et al. Consensus molecular subtypes and the evolution of precision medicine in colorectal cancer. Nature Reviews: Cancer, v. 17, p. 79-92, fev./2017.
DOORBAR, et al. Human papillomavirus molecular biology and disease association. John Wiley & Sons,
Ltd., Department of Pathology, University of Cambridge, Cambridge, UK, v. 25, n. 1, p. 2-23, jun./2014.
DUKERS-MUIJRERS, N. H. T. M. et al. What is needed to guide testing for anorectal and pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae in women and men? Evidence and opinion. BMC Infect Dis,
v. 15, n. 1, p. 533, nov./2015.
DURÃES L. C.; SOUSA J. B. Câncer anal e doenças sexualmente transmissíveis: Qual a correlação? Revista
do Colégio Brasileiro de Cirurgiões, Brasília, v. 37, n. 4, p. 265-268, 2010.
GRADY, W. M.; PRITCHARD, C. C. Molecular alterations and biomarkers in colorectal cancer. Toxicol
Pathol, v. 42, n. 1, p. 124-139, jan./2014.
GUNN, R. A. et al. Gonorrhea screening among men who have sex with men: value of multiple anatomic
site testing, San Diego, California, 1997-2003. Sexually Transmitted Diseases, San Diego, v. 35, n. 10, p.
HUYNH, et al. Oncogenic Properties of HIV-Tat in Colorectal Cancer Cells. Bentham Science Publishers
Ltd., v. 5, n. 4, p. 403-409, nov./2020.
INCA - Instituto Nacional do Câncer José Alencar Gomes da Silva. Registros de câncer de base populacional. Brasília: Ministério da Saúde, 2013.
KARKI, R.; MAN, S. M.; KANNEGANTI, T. Inflammasomes and Cancer. Cancer Immunology Research, v. 5,
n. 2, p. 1-7, fev./2017.
KUMAR, V.; ABBAS A. K.; FAUSTO, N.; ASTER, J. Robbins & Cotran Patologia - Bases patológicas das doenças. 9ª edição. Elsevier Editora Ltda. 2016.
LÓPEZ, L. S. Manifestaciones Coloproctológicas de las Infecciones de Transmisión Sexual Ocasionadas
por Chlamydia Trachomatis, Neisseria Gonorrhoeae y Treponema Pallidum. Presentación Casuística. Rev
Argent Coloproct, v. 30, n. 4, p. 80-87, set./2019.
MOOSSAVI, et al. Role of the NLRP3 inflammasome in cancer. Molecular Cancer, v. 17, n. 1, p. 158,
PACHECO-PEREZ, L. A. et al. Fatores ambientais e conscientização sobre o câncer colorretal em pessoas
com risco familiar. Rev. Latino-Am. Enfermagem, Ribeirão Preto, v.27, e3195, 2019.
PANDEY, A.; SHEN, C.; MAN, S. M. Inflammasomes in Colitis and Colorectal Cancer: Mechanism of Action
and Therapies. Yale Journal of Biology and Medicine, v. 92, p.481-498, 2019.
PAPACONSTANTINOU, H. T.; THOMAS, J. S. Bacterial Colitis. CLINICS IN COLON AND RECTAL SURGERY, 1
Department of Surgery, Division of Surgical Oncology, Section of Colon and Rectal Surgery, The Texas
A&M University System Health Science Center, Scott and White Hospital, Temple, Texas, v. 20, n. 1, p. 18-
PARREIRAS, F. C. et al. Aspectos genéticos do câncer colorretal e seu impacto no manejo da doença. Revista Médica de Minas Gerais, v. 23, n. 2, p. 221-227, mar./2011.
PELIZZER, T. et al. Prevalência de câncer colorretal associado ao papilomavírus humano: uma revisão sistemática com metanálise. Rev. bras. epidemiol, São Paulo, v. 19, n.4, p.791-802, dez./2016.
PERERA, A. P. et al. NLRP3 inflammasome in colitis and colitis-associated colorectal cancer. Mammalian
Genome, v.19, p. 817-830, set./2018.
PICANCO-JUNIOR, O. M. et al. Associação do Papilomavírus humano com o adenocarcinoma colorretal e
sua influência no estadio tumoral e no grau de diferenciação celular. ABCD, arq. bras. cir. dig, São Paulo,
v. 27, n. 3, p. 172-176, set./2014.
PINHO, M. D. S. L. Célula Tronco Tumoral: Novo Conceito em Carcinogênese Colorretal. Revista Brasileira
de Coloproctologia, v. 29, n. 1, p. 120-124, jan./2009.
SALEPCI, T. et al. Detection of human papilomavirus DNA by polymerase chain reaction and southern blot
hybridization in colorectal cancer patients. Journal of B.U.O.N, v. 14, p. 495-499, jul./2009.
SILVA, F. M. M. D. et al. Câncer colorretal em pacientes com idade inferior a 50 anos - experiência em cinco
anos. Rev. Col. Bras. Cir., Rio de Janeiro, v.47, e20202406, 2020.
SOUTO, R.; FALHARI, J. P. B; CRUZ, A. D. D. O Papilomavírus Humano: um fator relacionado com a formação de neoplasias. Revista Brasileira de Cancerologia, Goiânia, v. 51, n. 2, p. 155-160, mai./2005.
SOUZA, H. C. et al. Análise de adesão ao tratamento com antirretrovirais em pacientes com HIV/AIDS.
Revista Brasileira de Enfermagem, v. 5, n. 72, p. 1361-1369, 2019.
WANG, B. et al. The association of aberrant expression of NLRP3 and p-S6K1 in colorectal cancer. Pathology – Research and Practice, v. 216, n. 1, nov./2019.
WANG, H. et al. Inflammasome-independent NLRP3 is required for epithelial-mesenchymal transition in
colon cancer cells. Experimental Cell Research, v. 342, n. 2, p. 184-192, mar./2016.