Kuniyasu Hiroki
Hiroki Kuniyasu, Department of Molecular Pathology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Japan.
World J Clin Oncol. 2012 Dec 10;3(12):150-4. doi: 10.5306/wjco.v3.i12.150.
Colorectal cancer (CRC) cells express renin and chymase through which they can activate angiotensin. Renin expression is induced by hyperglycemic conditions. As angiotensinogen is produced in the liver, CRC cells that can activate angiotensin have an enhanced ability to metastasize to this organ. In human CRC cases, patients with diabetes have higher activities of rennin and angiotensin-II in primary tumors, and on average, have a more progressed disease stage, especially with respect to liver metastasis. These patients exhibit a stronger association with Hemoglobin A1c levels and metastasis compared to patients without diabetes. In a combined diabetes/CRC liver metastasis mouse model, concurrent treatment with anti-angiotensin and hypoglycemic agents shows a synergic effect in terms of reduced liver metastasis and improved survival. The effect of anti-angiotensin treatment and blood sugar control as a baseline management for colon cancer patients with diabetes needs to be examined in clinical trials to establish whether it can prevent liver metastasis.
结肠直肠癌（CRC）细胞表达肾素和糜酶，通过它们可激活血管紧张素。高血糖状况可诱导肾素表达。由于血管紧张素原在肝脏中产生，能够激活血管紧张素的CRC细胞转移至该器官的能力增强。在人类CRC病例中，糖尿病患者原发肿瘤中的肾素和血管紧张素-II活性较高，平均而言，疾病进展程度更高，尤其是在肝转移方面。与无糖尿病患者相比，这些患者的糖化血红蛋白水平与转移之间的关联更强。在糖尿病/CRC肝转移联合小鼠模型中，抗血管紧张素药物与降糖药物联合治疗在减少肝转移和提高生存率方面显示出协同效应。抗血管紧张素治疗和血糖控制作为糖尿病结肠癌患者的基线管理措施，其效果需要在临床试验中进行检验，以确定其是否能够预防肝转移。
