International Agency for Research on Cancer, 150 cours Albert Thomas, 69000 Lyon cedex 08, France.
Environ Health. 2011 Apr 5;10 Suppl 1(Suppl 1):S15. doi: 10.1186/1476-069X-10-S1-S15.
The last two decades have seen exciting advances in understanding the human genome, aided by the development of powerful analytical laboratory tools. These advances have enabled genome-wide association studies to link specific genetic variants with an altered risk of cancer. Unfortunately there has not been an analogous refinement of tools on such a comprehensive scale to permit an equally thorough investigation of environmental factors, yet it is known that these play a major role in cancer etiology. This limitation led to the suggested need for an exposome to match the genome. Major advances both in understanding mechanisms of carcinogenesis as well as in the technology to investigate these underlying steps in the disease process offer the potential to redress this imbalance between exposome and genome. This is all the more important in order to fully exploit the large prospective cohort studies with biological specimens now being established to investigate the environmental and genetic basis of common chronic diseases. Currently translational cancer research is understood to equate to a "bench to bedside" process, focused on improved clinical management of cancer. Unfortunately, alone, this is an inadequate response to the growing burden of cancer worldwide. Priority also needs to be placed on understanding the causes of cancer, its prevention and, critically, how to implement promising interventions into health care structures. The need therefore is to translate basic science to the population in parallel to the translation into the clinic. This "two-way" translational cancer research encourages the common soil of basic science to be applied both to the prevention of cancer and to its treatment. In this way the notable advances in relation to carcinogenesis will yield a richer benefit to society through balanced initiatives to understand the causes and prevention of cancer in addition to more effective treatment and care of those people developing the disease.
在过去的二十年中，随着强大的分析实验室工具的发展，人类基因组的理解取得了令人兴奋的进展。这些进展使全基因组关联研究能够将特定的遗传变异与癌症风险的改变联系起来。不幸的是，没有类似的工具在如此全面的范围内进行改进，以允许对环境因素进行同样彻底的调查，尽管已知这些因素在癌症病因学中起着重要作用。这一限制导致人们提出需要一个与基因组相匹配的暴露组。在理解致癌机制以及研究疾病过程中这些潜在步骤的技术方面的重大进展为纠正暴露组和基因组之间的这种不平衡提供了潜力。为了充分利用目前正在建立的具有生物标本的大型前瞻性队列研究来研究常见慢性疾病的环境和遗传基础，这一点更为重要。目前，转化癌症研究被理解为等同于“从实验室到病床”的过程，专注于改善癌症的临床管理。不幸的是，仅靠这一点，无法应对全球癌症负担的不断增加。还需要优先了解癌症的原因、预防，以及如何将有前途的干预措施纳入医疗保健结构。因此，需要将基础科学平行转化为人群，同时将其转化为临床。这种“双向”转化癌症研究鼓励将基础科学的共同点应用于癌症的预防和治疗。通过这种方式，与致癌作用相关的显著进展将通过平衡的癌症原因和预防措施的倡议，以及对那些患有该疾病的人的更有效治疗和护理，为社会带来更丰富的利益。
