Feng Hui-Yi, Chen Yang-Chao
Hui-Yi Feng, Yang-Chao Chen, School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, China.
World J Gastroenterol. 2016 Sep 7;22(33):7463-77. doi: 10.3748/wjg.v22.i33.7463.
The role of bile acids in colorectal cancer has been well documented, but their role in pancreatic cancer remains unclear. In this review, we examined the risk factors of pancreatic cancer. We found that bile acids are associated with most of these factors. Alcohol intake, smoking, and a high-fat diet all lead to high secretion of bile acids, and bile acid metabolic dysfunction is a causal factor of gallstones. An increase in secretion of bile acids, in addition to a long common channel, may result in bile acid reflux into the pancreatic duct and to the epithelial cells or acinar cells, from which pancreatic adenocarcinoma is derived. The final pathophysiological process is pancreatitis, which promotes dedifferentiation of acinar cells into progenitor duct-like cells. Interestingly, bile acids act as regulatory molecules in metabolism, affecting adipose tissue distribution, insulin sensitivity and triglyceride metabolism. As a result, bile acids are associated with three risk factors of pancreatic cancer: obesity, diabetes and hypertriglyceridemia. In the second part of this review, we summarize several studies showing that bile acids act as cancer promoters in gastrointestinal cancer. However, more question are raised than have been solved, and further oncological and physiological experiments are needed to confirm the role of bile acids in pancreatic cancer carcinogenesis.
胆汁酸在结直肠癌中的作用已有充分记载，但其在胰腺癌中的作用仍不清楚。在本综述中，我们研究了胰腺癌的危险因素。我们发现胆汁酸与大多数这些因素有关。饮酒、吸烟和高脂肪饮食都会导致胆汁酸分泌增加，而胆汁酸代谢功能障碍是胆结石的一个致病因素。除了长共同通道外，胆汁酸分泌增加可能导致胆汁酸反流至胰管以及胰腺腺癌起源的上皮细胞或腺泡细胞。最终的病理生理过程是胰腺炎，它促进腺泡细胞去分化为祖细胞样导管细胞。有趣的是，胆汁酸在代谢中作为调节分子，影响脂肪组织分布、胰岛素敏感性和甘油三酯代谢。因此，胆汁酸与胰腺癌的三个危险因素相关：肥胖、糖尿病和高甘油三酯血症。在本综述的第二部分，我们总结了几项研究，这些研究表明胆汁酸在胃肠道癌症中作为癌症促进剂起作用。然而，提出的问题比解决的问题更多，需要进一步的肿瘤学和生理学实验来证实胆汁酸在胰腺癌致癌作用中的作用。
