杨振丽, 刘玉琴. 癌症相关代谢紊乱综合征[J]. 中国肿瘤临床, 2007, 34(24): 1428-1432.
引用本文: 杨振丽, 刘玉琴. 癌症相关代谢紊乱综合征[J]. 中国肿瘤临床, 2007, 34(24): 1428-1432.
Yang Zhen-li, Liu Yu-qin. Metabolic Disorder Syndrome in Cancer Patients[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2007, 34(24): 1428-1432.
Citation: Yang Zhen-li, Liu Yu-qin. Metabolic Disorder Syndrome in Cancer Patients[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2007, 34(24): 1428-1432.

癌症相关代谢紊乱综合征

Metabolic Disorder Syndrome in Cancer Patients

  • 摘要: 临床上晚期癌症患者多表现为厌食、体重下降、早饱感、虚弱乏力及免疫力下降,这是癌症相关的代谢紊乱综合征所引起的,即恶病质,成为癌症患者死亡的主要原因之一。癌症代谢紊乱综合征与饥饿所引发的代谢紊乱是不同的,后者消耗大量的脂肪组织来维持肌肉组织中的蛋白含量,而前者脂肪和蛋白质都大量消耗,其中以蛋白质的消耗最为严重,使机体功能受损。现在有许多机制来解释癌症代谢紊乱综合征的病因,主要认为是由机体反应细胞或肿瘤细胞自身所产生的多种代谢因子所导致的,如TNF-α、IL-1、IL-6等。一些激素如糖皮质激素、瘦素、Ghrelin等也越来越受到研究者的重视。研究发现在癌症代谢紊乱综合征中这些激素水平发生了变化,但这种变化在该代谢紊乱病因中所起的作用还不清楚。这些因素在癌症代谢紊乱综合征中所起的作用不是十分确定,而且对该综合征所涉及的信号通路的研究也尚无定论。这些都给临床治疗带来了很大困难,仅靠补充营养并不能有效地增加癌症患者骨骼肌的蛋白含量。约三分之一的癌症患者最终因代谢紊乱死亡而非肿瘤本身。因此需要对癌症代谢紊乱的病因及其发生、发展过程进行更深入的研究,这些问题的解决不仅将有助于提高癌症患者的生活质量,对临床治疗也会有较大的帮助。

     

    Abstract: Patients with advanced cancer often have anorexia, weight loss, early satiety, fatigue,impaired immune response and other manifestations of metabolic disorder syndrome. The above state is called cancer cachexia and is an important cause of death in cancer patients. In starvation, fat from adipose tissue is consumed to maintain the content of protein in muscles, but in this syndrome, both fat and protein are consumed, leading to a serious decrease in protein stores. The etiology of this syndrome is thought to be a process mediated by catabolic factors secreted by immunoreactive cells or by tumor cells, such as TNF- α, IL- 1, IL- 6 and so on. In addition, the levels of some hormones like glucocorti-costeroid, leptin and Ghrelin in the patients with this syndrome are different from those of normal people. However, the role of hormone level changes as part of the mechanism of this syndrome is not entirely clear. At present, the clinical management of metabolic disorder syndrome in cancer patients is not satisfactory. Nutritional supplements cannot effectively restore the protein content in muscles. Almost 1/3 of patients with advanced cancer die from this metabolic disorder instead of the cancer itself.Research on this topic is needed to elucidate the exact mechanism of cachexia so that effective management can be developed and patients' quality of life can be improved.

     

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