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肥胖、胰岛素抵抗、脂肪细胞因子与乳腺癌:新的生物标志物及有吸引力的治疗靶点。

Obesity, insulin resistance, adipocytokines and breast cancer: New biomarkers and attractive therapeutic targets.

作者信息

Dalamaga Maria

机构信息

Maria Dalamaga, Department of Clinical Biochemistry, Medical School, University of Athens, "Attikon" General University Hospital, 12462 Athens, Greece.

出版信息

World J Exp Med. 2013 Aug 20;3(3):34-42. doi: 10.5493/wjem.v3.i3.34.

Abstract

Worldwide, breast cancer (BC) represents the most common type of non-skin human malignancy and the second leading cause of cancer-related deaths amid women in Western countries. Obesity and its metabolic complications have rapidly become major global health issues and are associated with increased risk for cancer, especially BC in postmenopausal women. Adipose tissue is considered as a genuine endocrine organ secreting a variety of bioactive adipokines, such as leptin, adiponectin, resistin and nicotinamide phosphoribosyl-transferase/visfatin. Recent evidence has indicated that the constellation of obesity, insulin resistance and adipokines is associated with the risk and prognosis of postmenopausal BC. Direct evidence is growing rapidly supporting the stimulating and/or inhibiting role of adipokines in the process of development and progression of BC. Adipokines could exert their effects on the normal and neoplastic mammary tissue by endocrine, paracrine and autocrine mechanisms. Recent studies support a role of adipokines as novel risk factors and potential diagnostic and prognostic biomarkers in BC. This editorial aims at providing important insights into the potential pathophysiological mechanisms linking adipokines to the etiopathogenesis of BC in the context of a dysfunctional adipose tissue and insulin resistance in obesity. A better understanding of these mechanisms may be important for the development of attractive preventive and therapeutic strategies against obesity-related breast malignancy.

摘要

在全球范围内,乳腺癌(BC)是最常见的非皮肤类人类恶性肿瘤,在西方国家女性中是癌症相关死亡的第二大主要原因。肥胖及其代谢并发症已迅速成为主要的全球健康问题,并与癌症风险增加相关,尤其是绝经后女性的乳腺癌。脂肪组织被认为是一个真正的内分泌器官,可分泌多种生物活性脂肪因子,如瘦素、脂联素、抵抗素和烟酰胺磷酸核糖转移酶/内脂素。最近的证据表明,肥胖、胰岛素抵抗和脂肪因子的组合与绝经后乳腺癌的风险和预后相关。越来越多的直接证据支持脂肪因子在乳腺癌发生和发展过程中的刺激和/或抑制作用。脂肪因子可通过内分泌、旁分泌和自分泌机制对正常和肿瘤性乳腺组织发挥作用。最近的研究支持脂肪因子作为乳腺癌新的风险因素以及潜在的诊断和预后生物标志物的作用。这篇社论旨在深入探讨在肥胖状态下脂肪组织功能失调和胰岛素抵抗的背景下,将脂肪因子与乳腺癌发病机制联系起来的潜在病理生理机制。更好地理解这些机制对于制定针对肥胖相关乳腺恶性肿瘤的有吸引力的预防和治疗策略可能很重要。

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