Clapper M L, Chang W C, Meropol N J
Division of Population Science, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.
Curr Opin Oncol. 2001 Jul;13(4):307-13. doi: 10.1097/00001622-200107000-00015.
Chemopreventive strategies hold substantial promise for reducing the incidence of colorectal cancer, the second leading cause of cancer-related mortality in the United States. This review focuses on recent advances in the identification of molecular targets and novel strategies for chemopreventive intervention. Many clinical trials are now in progress to assess the ability of synthetic agents or nutritional supplements to alter either the number of colorectal adenomas or biomarkers associated with colorectal tumorigenesis. Populations under study include genetically defined high-risk people and those with increased risk based on a personal history of colorectal neoplasia. A recent study showing that celecoxib, a cyclooxygenase-2 inhibitor, can alter the natural history of polyp formation in patients with familial adenomatous polyposis has provided a benchmark for the clinical development of other chemopreventive agents and heightened awareness that colorectal cancer is a preventable disease.
化学预防策略在降低结直肠癌发病率方面具有巨大潜力，结直肠癌是美国癌症相关死亡的第二大主要原因。本综述重点关注化学预防干预分子靶点识别和新策略方面的最新进展。目前正在进行许多临床试验，以评估合成药物或营养补充剂改变结直肠腺瘤数量或与结直肠癌发生相关生物标志物的能力。研究人群包括基因定义的高危人群以及基于结直肠肿瘤个人病史而风险增加的人群。最近一项研究表明，环氧化酶-2抑制剂塞来昔布可改变家族性腺瘤性息肉病患者息肉形成的自然病程，这为其他化学预防药物的临床开发提供了基准，并提高了人们对结直肠癌是一种可预防疾病的认识。
