Ganguli Mary
*Departments of Psychiatry and Neurology, School of Medicine †Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Alzheimer Dis Assoc Disord. 2015 Apr-Jun;29(2):177-82. doi: 10.1097/WAD.0000000000000086.
The relationship between dementia and cancer is complex. A wealth of observational data suggest (1) reduced risk of certain cancers in Alzheimer and Parkinson diseases; and (2) increased risk of other cancers in Parkinson disease. These relationships persist despite correcting for reporting artifacts and survival bias. Several potential mechanisms have been proposed and warrant further investigation. Aging is a risk factor for both. Common environmental exposures, such as smoking, may play roles. Common mechanisms such as chronic inflammation and immunosenescence, and common risk factors such as diabetes and obesity, have been implicated. Shared genetic pathways are a major focus, particularly those favoring apoptosis and cell proliferation at opposite ends of the spectrum. To complicate the picture further, certain cancer chemotherapy and adjuvant therapy agents have neurotoxic effects, whereas animal studies show other cancer drugs reducing neurodegeneration, raising the possibility of repurposing those agents for use in Alzheimer disease. These multiple potential lines of evidence must be disentangled to investigate underlying mechanisms, the end-game being to develop and to test potential prevention and treatment strategies.
痴呆症与癌症之间的关系很复杂。大量观察数据表明：（1）阿尔茨海默病和帕金森病患者患某些癌症的风险降低；（2）帕金森病患者患其他癌症的风险增加。尽管对报告偏倚和生存偏差进行了校正，这些关系依然存在。已经提出了几种潜在机制，值得进一步研究。衰老两者的一个风险因素。常见的环境暴露因素，如吸烟，可能起作用。慢性炎症和免疫衰老等共同机制以及糖尿病和肥胖等共同风险因素也与之相关。共享的遗传途径是一个主要研究重点，特别是那些在谱系两端有利于细胞凋亡和细胞增殖的途径。更复杂的是，某些癌症化疗和辅助治疗药物具有神经毒性作用，而动物研究表明其他癌症药物可减少神经退行性变，这增加了将这些药物重新用于治疗阿尔茨海默病的可能性。必须理清这些多条潜在证据线索，以研究潜在机制，最终目标是开发和测试潜在的预防和治疗策略。
