Birmingham Heartland Hospital, Birmingham B9 5SS, United Kingdom.
Surgeon. 2012 Feb;10(1):43-52. doi: 10.1016/j.surge.2011.07.003. Epub 2011 Nov 29.
Colorectal chemoprevention is a strategy aimed at preventing tumour progression before irreversible changes to the proteome are in full progress. Chemoprevention is not a new concept. In fact, medical practitioners since the early 19th century have tried various herbal and medicinal products as methods that could prevent tumours. The current understanding of tumourigenesis and cellular signalling focuses on a more targeted approach and paves the way for better understanding of colorectal chemoprevention.
The online databases PubMed, Medline, Medscape Oncology and Scirrus were searched for articles of relevance. The Keyword involved the following words: "Colorectal Cancer Chemoprevention", "Colorectal Cancer", "Chemoprevention", "Adenoma-Carcinoma Sequence" and "Colorectal Polyps". The search was started from the period of June 1995 until September 2010 inclusive.
More than 50 natural and synthetic compounds have been shown to have chemotherapeutic effect but the majority of these agents are still in their early experimental stages and hence far from our subject of discussion. Our discussion will focus on large scale randomised trials on human subjects or established compounds. Within the context of chemoprevention, Non-steroidal anti-inflammatory agents have undergone extensive research and have shown promising results with large scale randomised trials. Additionally, metformin, resveratrol, Histone deacetylase inhibitors, Src kinases as well monoclonal antibodies have shown promising results as well.
Colorectal cancer is the fourth most common cancer in the world. In the UK alone the number of cases reported in 2008 was almost 40,000 which make it the third most common tumour nationwide. Curative intent surgery or Colectomy is the treatment of choice for most cases of bowel cancer; however, in a select subpopulation of patients who have been colonoscopically diagnosed to harbour pre-malignant lesions, have a family history of colorectal cancer, or have been genetically diagnosed and treated surgically for colorectal tumours; chemoprevention might play a crucial role in deterring further tumour progression. The very latest studies that are in publication or are just accruing results are giving us encouraging data that might suggest whether mass scale ingestion of a specific medication might deter colorectal tumour progression.
结直肠癌化学预防旨在阻止蛋白质组发生不可逆转改变之前阻止肿瘤进展。化学预防并不是一个新概念。事实上，自 19 世纪初以来，医疗从业者就尝试了各种草药和药物作为预防肿瘤的方法。目前对肿瘤发生和细胞信号转导的认识侧重于更有针对性的方法，并为更好地理解结直肠癌化学预防铺平了道路。
在线数据库 PubMed、Medline、Medscape Oncology 和 Scirrus 搜索了相关文章。关键词涉及以下词语：“结直肠癌化学预防”、“结直肠癌”、“化学预防”、“腺瘤-癌序列”和“结直肠息肉”。搜索从 1995 年 6 月到 2010 年 9 月。
已经证明超过 50 种天然和合成化合物具有化疗作用，但这些药物中的大多数仍处于早期实验阶段，因此远未达到我们讨论的主题。我们的讨论将集中在人类受试者的大规模随机试验或已建立的化合物上。在化学预防的背景下，非甾体抗炎药已经进行了广泛的研究，并在大规模随机试验中显示出有希望的结果。此外，二甲双胍、白藜芦醇、组蛋白去乙酰化酶抑制剂、Src 激酶以及单克隆抗体也显示出有希望的结果。
结直肠癌是世界上第四大常见癌症。仅在英国，2008 年报告的病例数就接近 4 万例，使其成为全国第三大常见肿瘤。有治愈意图的手术或结肠切除术是大多数结直肠癌患者的首选治疗方法；然而，在一小部分已被结肠镜诊断为具有恶性前病变、有结直肠癌家族史或已被遗传诊断并接受结直肠肿瘤手术治疗的患者中，化学预防可能在阻止进一步肿瘤进展方面发挥关键作用。最新的正在发表或正在积累结果的研究为我们提供了令人鼓舞的数据，这些数据可能表明大规模摄入某种特定药物是否可以阻止结直肠肿瘤的进展。
