Austin Health, Department of Surgery, The University of Melbourne, Heidelberg, Vic., Australia.
Liver Int. 2010 Nov;30(10):1414-26. doi: 10.1111/j.1478-3231.2010.02306.x.
Liver resection is the most effective treatment for primary liver tumours and metastasis to the liver, and remains the only potentially long-term curative therapy for patients with colorectal cancer (CRC) liver metastases. Nevertheless, there is a significant incidence of tumour recurrence following liver resection. Cellular and molecular changes resulting from resection and the subsequent liver regeneration process may influence the kinetics of tumour growth, contributing to recurrence. Although commonly associated with the systemic homeostasis of blood pressure, fluid and electrolyte, the renin-angiotensin system (RAS) has recently been shown to play a role in regulating cell proliferation, apoptosis and angiogenesis in local organs as well as in malignancies. An electronic search of the English literature on the role of the RAS in liver regeneration and tumourigenesis was performed using PubMed, with additional relevant articles sourced from reference lists. Studies have shown that the blockade of the RAS pathway stimulates liver regeneration and inhibits tumour progression. An understanding of the role of RAS in liver regeneration and tumourigenesis may enable alternative strategies to improve patient outcome and survival after liver resection. This review will discuss the role of the RAS in liver regeneration and in tumour recurrence post-liver resection. The potential of the RAS as a novel therapeutic target for CRC liver metastases patients undergoing liver resection will be outlined.
肝切除术是原发性肝癌和肝转移的最有效治疗方法，仍然是结直肠癌（CRC）肝转移患者唯一潜在的长期治愈疗法。然而，肝切除术后肿瘤复发的发生率仍然很高。切除和随后的肝再生过程中细胞和分子的变化可能影响肿瘤生长的动力学，从而导致复发。尽管肾素-血管紧张素系统（RAS）通常与血压、液体和电解质的全身内环境稳定有关，但最近已经表明，它在调节局部器官中的细胞增殖、凋亡和血管生成以及恶性肿瘤中发挥作用。使用 PubMed 对 RAS 在肝再生和肿瘤发生中的作用的英文文献进行了电子检索，并从参考文献中获取了其他相关文章。研究表明，RAS 途径的阻断刺激肝再生并抑制肿瘤进展。了解 RAS 在肝再生和肿瘤发生中的作用可能为改善肝切除术后患者的预后和生存提供替代策略。本文将讨论 RAS 在肝再生和肝切除术后肿瘤复发中的作用。概述了 RAS 作为接受肝切除术的 CRC 肝转移患者的新型治疗靶点的潜力。
