结直肠癌（CRC）是全球发病率和死亡率的重要来源，迫切需要改进预防和治疗策略。随着我们对结直肠癌了解的加深，越来越明显的是，肠道微生物群由数万亿与结肠直接接触的微生物组成，在结直肠癌的发生和进展中发挥着重要作用。了解个体微生物和复杂微生物群落在结直肠癌发病机制中所起的作用及其伴随机制，将有助于产生新的结直肠癌预防和治疗干预措施。在这篇综述中，我们讨论了有关 CRC 肠道微生物群整体扰动的最新证据、特定微生物与 CRC 的关联、微生物潜在驱动 CRC 发展的潜在机制以及复杂微生物群落在 CRC 发病机制中的作用。尽管近年来我们对微生物群与结直肠癌之间关系的了解有所提高，但我们的研究结果凸显了当前研究中存在的巨大空白，需要填补这些空白才能将这些知识用于造福患者。© 2023。Springer Nature Limited。

Colorectal cancer (CRC) is a substantial source of global morbidity and mortality in dire need of improved prevention and treatment strategies. As our understanding of CRC grows, it is becoming increasingly evident that the gut microbiota, consisting of trillions of microorganisms in direct interface with the colon, plays a substantial role in CRC development and progression. Understanding the roles that individual microorganisms and complex microbial communities play in CRC pathogenesis, along with their attendant mechanisms, will help yield novel preventive and therapeutic interventions for CRC. In this Review, we discuss recent evidence concerning global perturbations of the gut microbiota in CRC, associations of specific microorganisms with CRC, the underlying mechanisms by which microorganisms potentially drive CRC development and the roles of complex microbial communities in CRC pathogenesis. While our understanding of the relationship between the microbiota and CRC has improved in recent years, our findings highlight substantial gaps in current research that need to be filled before this knowledge can be used to the benefit of patients.© 2023. Springer Nature Limited.