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Role and related mechanisms of Porphyromonas gingivalis in the occurrence and development of digestive system tumors

Published on Apr. 01, 2026Total Views: 15 timesTotal Downloads: 1 timesDownloadMobile

Author: LI Jingya 1, 2 SUN Jiachun 1 KONG Jinyu 2 GAO Shegan 1, 2

Affiliation: 1. Department of Gastroenterology, Cancer Hospital, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471000, Henan Province, China 2. Henan Key Laboratory of Microecology and Esophageal Cancer Prevention and Treatment, Luoyang 471000, Henan Province, China

Keywords: Porphyromonas gingivalis Digestive system Tumor pathogenesis and progression Molecular mechanism

DOI: 10.12173/j.issn.1004-5511.202408034

Reference: Li JY, Sun JC, Kong JY, et al. Role and related mechanisms of Porphyromonas gingivalis in the occurrence and development of digestive system tumors[J]. Yixue Xinzhi Zazhi, 2026, 36(3): 342-347. DOI: 10.12173/j.issn.1004-5511.202408034. [Article in Chinese]

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Abstract

The pathogenic role of Porphyromonas gingivalis (P. gingivalis), a key pathogen in periodontitis, has been well documented to extend far beyond the oral cavity. P. gingivalis can be specifically detected in digestive system tumor tissues, and its infection abundance is closely associated with tumor invasion, metastasis, and poor prognosis in patients. This study systematically reviews basic and clinical research on the association between P. gingivalis and digestive system tumors including oral cancer, esophageal cancer, pancreatic cancer, liver cancer, and colorectal cancer. The potential molecular mechanisms underlying P. gingivalis-induced tumor initiation and progression were further elucidated thoroughly, aiming to provide new theoretical basis and research directions for risk warning, early diagnosis, and targeted therapy of digestive system  tumors.

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1. Chigasaki O, Aoyama N, Sasaki Y, et al. Porphyromonas gingivalis, the most influential pathogen in red-complex bacteria: a cross-sectional study on the relationship between bacterial count and clinical periodontal status in Japan[J]. J Periodontol, 2021, 92(12): 1719-1729.

2. Sayehmiri F, Sayehmiri K, Asadollahi K, et al. The prevalence rate of Porphyromonas gingivalis and its association with cancer: a systematic review and Meta-analysis[J]. Int J Immunopathol Pharmacol, 2015, 28(2): 160-167.

3. Kawasaki M, Ikeda Y, Ikeda E, et al. Oral infectious bacteria in dental plaque and saliva as risk factors in patients with esophageal cancer[J]. Cancer, 2021, 127(4): 512-519.

4. Isono H, Nakajima S, Watanabe S, et al. Involvement of oral microbiome in the development of oral malignancy[J]. Cancers (Basel), 2025, 17(4): 632.

5. Motosugi S, Takahashi N, Mineo S, et al. Enrichment of porphyromonas gingivalis in colonic mucosa-associated microbiota and its enhanced adhesion to epithelium in colorectal carcinogenesis: insights from in vivo and clinical studies[J]. PLoS One, 2025, 20(3): e0320383.

6. Sztukowska MN, Ojo A, Ahmed S, et al. Porphyromonas gingivalis initiates a mesenchymal-like transition through ZEB1 in gingival epithelial cells[J]. Cell Microbiol, 2016, 18(6): 844-858.

7. Groeger SE, Hudel M, Zechel-Gran S, et al. Recombinant Porphyromonas gingivalis W83 FimA alters immune response and metabolic gene expression in oral squamous carcinoma cells[J]. Clin Exp Dent Res, 2022, 8(4): 976-987.

8. Michaud DS, Izard J, Wilhelm-Benartzi CS, et al. Plasma antibodies to oral bacteria and risk of pancreatic cancer in a large European prospective cohort study[J]. Gut, 2013, 62(12): 1764-1770.

9. Yuan X, Liu Y, Kong J, et al. Different frequencies of Porphyromonas gingivalis infection in cancers of the upper digestive tract[J]. Cancer Lett, 2017, 404: 1-7.

10. Gao S, Li S, Ma Z, et al. Presence of Porphyromonas gingivalis in esophagus and its association with the clinicopathological characteristics and survival in patients with esophageal cancer[J]. Infect Agent Cancer, 2016, 11: 3.

11. Kinskey JC, Huda TI, Gozlan EC, et al. The presence of intratumoral Porphyromonas gingivalis correlates with a previously defined pancreatic adenocarcinoma, immune cell expression phenotype and with tumor resident, adaptive immune receptor features[J]. Carcinogenesis, 2023, 44(5): 411-417.

12. Katz J, Onate MD, Pauley KM, et al. Presence of Porphyromonas gingivalis in gingival squamous cell carcinoma[J]. Int J Oral Sci, 2011, 3(4): 209-215.

13. Park DG, Woo BH, Lee BJ, et al. Serum levels of interleukin-6 and titers of antibodies against porphyromonas gingivalis could be potential biomarkers for the diagnosis of oral squamous cell carcinoma[J]. Int J Mol Sci, 2019, 20(11): 2749.

14. Wen L, Mu W, Lu H, et al. Porphyromonas gingivalis promotes oral squamous cell carcinoma progression in an immune microenvironment[J]. J Dent Res. 2020, 99(6): 666-675.

15. Guo ZC, Jing SL, Jumatai S, et al. Porphyromonas gingivalis promotes the progression of oral squamous cell carcinoma by activating the neutrophil chemotaxis in the tumour microenvironment[J]. Cancer Immunol Immunother, 2023, 72(6): 1523-1539.

16. Li C, Li M, Wei W, et al. Association of DOK3 and infiltrated tumor-associated macrophages with risk for the prognosis of Porphyromonas gingivalis-infected oral cancer: a 12-year data analysis of 200 patients from a tertiary teaching hospital, Urumqi, China[J]. BMC Cancer, 2024, 24(1): 534.

17. Gao SG, Yang JQ, Ma ZK, et al. Preoperative serum immunoglobulin G and A antibodies to Porphyromonas gingivalis are potential serum biomarkers for the diagnosis and prognosis of esophageal squamous cell carcinoma[J]. BMC Cancer, 2018, 18(1): 17.

18. Maboudi A, Hajifathalian K, Negahban Z, et al. Correlation of Porphyromonas gingivalis with esophageal squamous cell carcinoma: a systematic review[J]. Clin Oral Investig, 2024, 29(1): 1.

19. Gao SG, Qi ZP, Qi YJ, et al. Porphyromonas gingivalis predicts local recurrence after endoscopic submucosal dissection of early esophageal squamous cell carcinoma or precancerous lesion[J]. BMC Cancer, 2023, 23(1): 43.

20. Gao S, Liu Y, Duan X, et al. Porphyromonas gingivalis infection exacerbates oesophageal cancer and promotes resistance to neoadjuvant chemotherapy[J]. Br J Cancer, 2021, 125(3): 433-444.

21. Petrick JL, Wilkinson JE, Michaud DS, et al. The oral microbiome in relation to pancreatic cancer risk in African Americans[J]. Br J Cancer, 2022, 126(2): 287-296.

22. Fan X, Alekseyenko AV, Wu J, et al. Human oral microbiome and prospective risk for pancreatic cancer: a population-based nested case-control study[J]. Gut, 2018, 67(1): 120-127.

23. Tan Q, Ma X, Yang B, et al. Periodontitis pathogen Porphyromonas gingivalis promotes pancreatic tumorigenesis via neutrophil elastase from tumor-associated neutrophils[J]. Gut Microbes, 2022, 14(1): 2073785.

24. Zhu Y, Liang X, Zhi M, et al. Succession of the multi-site microbiome along pancreatic ductal adenocarcinoma tumorigenesis[J]. Front Immunol, 2024, 15: 1487242.

25. Yoneda M, Naka S, Nakano K, et al. Involvement of a periodontal pathogen, Porphyromonas gingivalis on the pathogenesis of non-alcoholic fatty liver disease[J]. BMC Gastroenterol, 2012, 12: 16.

26. Yang T, Lei Y, Liao L, et al. Global, regional, and national burden of liver cancer due to non-alcoholic steatohepatitis and non-alcoholic fatty liver disease, 1990-2021: a multi-model trend analysis and forecasting study[J]. Hepatol Int, 2025, 19(3): 619-632.

27. Matsui T, Morozumi T, Yamamoto Y, et al. Relationship of metabolic dysfunction-associated steatohepatitis-related hepatocellular carcinoma with oral and intestinal microbiota: a cross-sectional pilot study[J]. Medicina(Kaunas), 2024, 60(7): 1120.

28. Kerdreux M, Edin S, Löwenmark T, et al. Porphyromonas gingivalis in colorectal cancer and its association to patient prognosis[J]. J Cancer, 2023, 14(9): 1479-1485.

29. Wang X, Jia Y, Wen L, et al. Porphyromonas gingivalis promotes colorectal carcinoma by activating the hematopoietic NLRP3 inflammasome[J]. Cancer Res, 2021, 81(10): 2745-2759.

30. Purcell RV, Visnovska M, Biggs PJ, et al. Distinct gut microbiome patterns associated with consensus molecular subtypes of colorectal cancer[J]. Sci Rep, 2017, 7(1): 11590.

31. Ha NH, Woo BH, Kim DJ, et al. Prolonged and repetitive exposure to Porphyromonas gingivalis increases aggressiveness of oral cancer cells by promoting acquisition of cancer stem cell properties[J]. Tumour Biol, 2015, 36(12): 9947-9960.

32. Kamarajan P, Ateia I, Shin JM, et al. Periodontal pathogens promote cancer aggressivity via TLR/MyD88 triggered activation of Integrin/FAK signaling that is therapeutically reversible by a probiotic bacteriocin[J]. PLoS Pathog, 2020, 16(10): e1008881.

33. Zang W, Geng F, Liu J, et al. Porphyromonas gingivalis potentiates stem-like properties of oral squamous cell carcinoma by modulating SCD1-dependent lipid synthesis via NOD1/KLF5 axis[J]. Int J Oral Sci, 2025, 17(1): 15.

34. Chang C, Wang H, Liu J, et al. Porphyromonas gingivalis infection promoted the proliferation of oral squamous cell carcinoma cells through the miR-21/PDCD4/AP-1 negative signaling pathway[J]. ACS Infect Dis, 2019, 5(8): 1336-1347.

35. Yuan K, Xu S, Liu G, et al. Porphyromonas gingivalis promotes oral squamous cell carcinoma progression by modulating autophagy[J]. Oral Dis, 2025, 31(2): 492-502.

36. Lee J, Roberts JS, Atanasova KR, et al. Human primary epithelial cells acquire an epithelial-mesenchymal-transition phenotype during long-term infection by the oral opportunistic pathogen, Porphyromonas gingivalis[J]. Front Cell Infect Microbiol, 2017, 7: 493.

37. Binder Gallimidi A, Fischman S, Revach B, et al. Periodontal pathogens Porphyromonas gingivalis and Fusobacterium nucleatum promote tumor progression in an oral-specific chemical carcinogenesis model[J]. Oncotarget, 2015, 6(26): 22613-22623.

38. Liao X, Si H, Lai Y, et al. Porphyromonas gingivalis-OMVs promote the epithelial-mesenchymal transition of oral squamous cell carcinoma by inhibiting ferroptosis through the NF-κB pathway[J]. J Oral Microbiol, 2025, 17(1): 2482924.

39. Inaba H, Sugita H, Kuboniwa M, et al. Porphyromonas gingivalis promotes invasion of oral squamous cell carcinoma through induction of proMMP9 and its activation[J]. Cell Microbiol, 2014, 16(1): 131-145.

40. Inaba H, Amano A, Lamont RJ, et al. Involvement of protease-activated receptor 4 in over-expression of matrix metalloproteinase 9 induced by Porphyromonas gingivalis[J]. Med Microbiol Immunol, 2015, 204(5): 605-612.

41. Guo ZC, Jing SL, Jia XY, et al. Porphyromonas gingivalis promotes the progression of oral squamous cell carcinoma by stimulating the release of neutrophil extracellular traps in the tumor immune microenvironment[J]. Inflamm Res, 2024, 73(5): 693-705.

42. Groeger S, Domann E, Gonzales JR, et al. B7-H1 and B7-DC receptors of oral squamous carcinoma cells are upregulated by Porphyromonas gingivalis[J]. Immunobiology, 2011, 216(12): 1302-1310.

43. Groeger S, Jarzina F, Domann E, et al. Porphyromonas gingivalis activates NFκB and MAPK pathways in human oral epithelial cells[J]. BMC Immunol, 2017, 18(1): 1.

44. Liu S, Zhou X, Peng X, et al. Porphyromonas gingivalis promotes immunoevasion of oral cancer by protecting cancer from macrophage attack[J]. J Immunol, 2020, 205(1): 282-289

45. Woo BH, Kim DJ, Choi JI, et al. Oral cancer cells sustainedly infected with Porphyromonas gingivalis exhibit resistance to Taxol and have higher metastatic potential[J]. Oncotarget, 2017, 8(29): 46981-46992.

46. Song JM, Woo BH, Lee JH, et al. Oral administration of Porphyromonas gingivalis, a major pathogen of chronic periodontitis, promotes resistance to paclitaxel in mouse xenografts of oral squamous cell carcinoma[J]. Int J Mol Sci, 2019, 20(10): 2494.

47. Jia X, Liu J, He Y, et al. Porphyromonas gingivalis secretion leads to dysplasia of normal esophageal epithelial cells via the Sonic hedgehog pathway[J]. Front Cell Infect Microbiol, 2022, 12: 982636.

48. Liang G, Wang H, Shi H, et al. Porphyromonas gingivalis promotes the proliferation and migration of esophageal squamous cell carcinoma through the miR-194/GRHL3/PTEN/Akt Axis[J]. ACS Infect Dis, 2020, 6(5): 871-881.

49. 申刘青, 张顶彧, 高社干. 牙龈卟啉单胞菌感染对食管癌细胞内 IFNGR1 棕榈酰化位点突变的影响[J]. 南方医科大学学报, 2023, 43(7): 1155-1163. [Shen LQ, Zhang DY, Gao  SG. Effect of Porphyromonas gingivalis infection on IFNGR1 palmitoylation in esophageal cancer cells[J]. Journal of Southern Medical University, 2023, 43(7): 1155-1163.]

50. Meng F, Li R, Ma L, et al. Porphyromonas gingivalis promotes the motility of esophageal squamous cell carcinoma by activating NF-κB signaling pathway[J]. Microbes Infect, 2019, 21(7): 296-304.

51. Chen MF, Lu MS, Hsieh CC, et al. Porphyromonas gingivalis promotes tumor progression in esophageal squamous cell carcinoma[J]. Cell Oncol (Dordr), 2021, 44(2): 373-384.

52. 许海军, 齐义军, 伍当柔, 等. 牙龈卟啉单胞菌诱发炎症微环境促进食管鳞状细胞癌发生[J]. 中华肿瘤杂志, 2024, 46(8): 746-754. [Xu HJ, Qi YJ, Wu DR, et al. Porphyromonas gingivalis promotes the occurrence of esophageal squamous cell carcinoma via an inflammatory microenvironment[J]. Chinese Journal of Oncology, 2024, 46(8): 746-754.]

53. Gao S, Liu K, Jiao Y, et al. Selective activation of TGFβ signaling by P. gingivalis-mediated upregulation of GARP aggravates esophageal squamous cell carcinoma[J]. Am J Cancer Res, 2023, 13(5): 2013-2029.

54. Yuan X, Liu Y, Li G, et al. Blockade of immune-checkpoint B7-H4 and lysine demethylase 5B in esophageal squamous cell carcinoma confers protective immunity against P. gingivalis infection[J]. Cancer Immunol Res, 2019, 7(9): 1440-1456.

55. 杨泽, 张秀森, 张旭东, 等. 基于YTHDF2介导凋亡相关因子降解途径研究牙龈卟啉单胞菌协助食管癌免疫逃逸[J]. 南方医科大学学报, 2024, 44(6): 1159-1165. [Yang Z, Zhang XS, Zhang  XD, et al. Porphyromonas gingivalis infection facilitates immune escape of esophageal cancer by enhancing YTHDF2-mediated Fas degradation[J]. Journal of Southern Medical University, 2024, 44(6): 1159-1165.]

56. Kong J, Liu Y, Wang J, et al. A novel Porphyromonas gingivalis infection-related inflammatory response-related genes signature predicts the prognosis of esophageal squamous cell carcinoma[J]. Clin Med Insights Oncol, 2024, 18: 11795549241275666.

57. Li R, Liu Y, Zhou F, et al. Clinical significance of Porphyromonas gingivalis enriching cancer stem cells by inhibiting programmed cell death factor 4 in esophageal squamous cell carcinoma[J]. ACS Infect Dis, 2023, 9(10): 1846-1857.

58. Liu Y, Zhou F, Yang H, et al. Porphyromonas gingivalis promotes malignancy and chemo-resistance via GSK3β-mediated mitochondrial oxidative phosphorylation in human esophageal squamous cell carcinoma[J]. Transl Oncol, 2023, 32: 101656.

59. Saba E, Farhat M, Daoud A, et al. Oral bacteria accelerate pancreatic cancer development in mice[J]. Gut, 2024, 73(5): 770-786.

60. Chen SM, Hsu LJ, Lee HL, et al. Lactobacillus attenuate the progression of pancreatic cancer promoted by Porphyromonas gingivalis in K-ras(G12D) transgenic mice[J]. Cancers(Basel), 2020, 12(12): 3678.

61. Hiraki D, Uehara O, Kuramitsu Y, et al. P. gingivalis lipopolysaccharide stimulates the upregulated expression of the pancreatic cancer-related genes regenerating islet-derived 3 A/G in mouse pancreas[J]. Int J Mol Sci, 2020, 21(19): 7196.

62. Gnanasekaran J, Binder Gallimidi A, Saba E, et al. Intracellular Porphyromonas gingivalis promotes the tumorigenic behavior of pancreatic carcinoma cells[J]. Cancers (Basel), 2020, 12(8): 2217.

63. Sakamoto S, Nagasaki A, Shrestha M, et al. Porphyromonas gingivalis-odontogenic infection is the potential risk for progression of nonalcoholic steatohepatitis-related neoplastic nodule formation[J]. Sci Rep, 2023, 13(1): 9350.

64. Takano M, Sugano N, Mochizuki S, et al. Hepatocytes produce tumor necrosis factor-α and interleukin-6 in response to Porphyromonas gingivalis[J]. J Periodontal Res, 2012, 47(1): 89-94.

65. Díaz-Basabe A, Lattanzi G, Perillo F, et al. Porphyromonas gingivalis fuels colorectal cancer through CHI3L1-mediated iNKT cell-driven immune evasion[J]. Gut Microbes, 2024, 16(1): 2388801.

66. Lin FY, Huang CY, Lu HY, et al. The GroEL protein of Porphyromonas gingivalis accelerates tumor growth by enhancing endothelial progenitor cell function and neovascularization[J]. Mol Oral Microbiol, 2015, 30(3): 198-216.

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