肥胖及肥胖相关病症对结直肠癌预后的影响。

The effects of obesity and obesity-related conditions on colorectal cancer prognosis.

机构信息

Risk Assessment, Detection and Intervention Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.

出版信息

Cancer Control. 2010 Jan;17(1):52-7. doi: 10.1177/107327481001700107.

DOI:10.1177/107327481001700107

PMID:20010519

Abstract

BACKGROUND

Colorectal cancer is the second-leading cause of cancer death in the United States among men and women combined. Refinements in screening, staging, and treatment strategies have improved survival from this disease, with over 65% of patients diagnosed with colorectal cancer surviving over 5 years after diagnosis. In the prognosis of colorectal cancer, clinicopathological factors are important. However, modifiable prognostic factors are emerging as significant contributors to cancer outcomes, including obesity and obesity-related inflammation and metabolic conditions.

METHODS

This report reviews the literature on obesity and obesity-related inflammation and metabolic disturbances and colorectal cancer outcomes (recurrence, disease-free survival, and/or mortality). A PubMed search was conducted of all English-language papers published between August 2003 and 2009 and cited in MEDLINE.

RESULTS

Primary research papers were reviewed for colorectal cancer outcomes related to obesity, inflammation, or metabolic conditions. An association between body size and colorectal cancer recurrence and possibly survival was found; however, reports have been inconsistent. These inconsistent findings may be due to the complex interaction between adiposity, physical inactivity, and dietary intake. Circulating prognostic markers such as C-reactive protein, insulin-like growth factor, and insulin, alone or in combination, have been associated with prognosis in observational studies and should be evaluated in randomized trials and considered for incorporation into surveillance.

CONCLUSIONS

The literature suggests that obesity and obesity-related inflammation and metabolic conditions contribute to the prognosis of colorectal cancer; however, comprehensive large scale trials are needed. Interventions to reduce weight and control inflammation and metabolic conditions, such as diabetes, need to be evaluated and rapidly translated to behavior guidelines for patients.

摘要

背景

在美国，结直肠癌是男性和女性癌症死亡的第二大主要原因。筛查、分期和治疗策略的改进提高了这种疾病的生存率，超过 65%的结直肠癌患者在诊断后 5 年以上仍能存活。在结直肠癌的预后中，临床病理因素很重要。然而，可改变的预后因素正在成为癌症结果的重要贡献者，包括肥胖症以及肥胖症相关的炎症和代谢紊乱。

方法

本报告综述了肥胖症和肥胖症相关的炎症和代谢紊乱与结直肠癌结局（复发、无病生存率和/或死亡率）相关的文献。对 2003 年 8 月至 2009 年间发表在 MEDLINE 并被引用的所有英文论文进行了 PubMed 检索。

结果

对与肥胖、炎症或代谢状况相关的结直肠癌结局的主要研究论文进行了综述。发现体重与结直肠癌复发和可能的生存之间存在关联；然而，报告结果并不一致。这些不一致的发现可能是由于肥胖、身体不活动和饮食摄入之间的复杂相互作用。在观察性研究中，循环预后标志物如 C 反应蛋白、胰岛素样生长因子和胰岛素单独或联合与预后相关，应在随机试验中进行评估，并考虑纳入监测。