REVIEW article
Front. Microbiol.
Sec. Microorganisms in Vertebrate Digestive Systems
This article is part of the Research TopicUnlocking the Potential of the Microbiome in Cancer TherapyView all 11 articles
Analyzing the gut liver axis: a dual role of the microbiome in the genesis, progression, and treatment of liver cell carcinoma
Provisionally accepted
Qianzhu Li1
Yafang Liu1,2*- 1Zhejiang Chinese Medical University School of Basic Medical Sciences, Hangzhou, China
- 2Zhejiang Key Laboratory of Blood-Stasis-Toxin Syndrome, Hangzhou, China
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Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, and the poor prognosis highlights the pressing need for innovative therapeutic strategies. The gut-liver axis, a critical bidirectional pathway linking the gut microbiota to the liver, plays a pivotal role in HCC pathogenesis. This review systematically delineates current evidence on how gut dysbiosis, compromised intestinal barrier function, and resultant microbial metabolites (e.g., bacterially me-tabolized bile acids) drive hepatocarcinogenesis via specific signaling pathways, while also ad-dressing the loss of protective effects due to the depletion of beneficial microbes. Moving beyond descriptive summaries, this article focuses on elucidating the core molecular mechanisms of mi-crobiome-regulated HCC—a key knowledge gap that remains unaddressed—and reconciles con-flicting findings into a unified framework. We further explore the translational potential of micro-biome signatures as non-invasive biomarkers and evaluate microbiota-targeting interventions (e.g., probiotics, dietary modulation, fecal microbiota transplantation) for enhancing treatment efficacy. Ultimately, this review aims to provide a clear roadmap for developing microbiome-based precision medicine in HCC, with the goal of improving clinical management and patient outcomes.
Keywords: Gut Microbiota, gut metabolites, Gut-liver axis, Hepatocellular Carcinoma, dual regulation
Received: 08 Sep 2025; Accepted: 04 Nov 2025.
Copyright: © 2025 Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yafang Liu, 20231123@zcmu.edu.cn
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