Labochka Dominika, Moszczuk Barbara, Kukwa Wojciech, Szczylik Cezary, Czarnecka Anna M
Department of Oncology, Military Institute of Medicine, Warsaw, Poland.
Department of Otolaryngology, Czerniakowski Hospital, Medical University of Warsaw, Warsaw, Poland.
Int J Mol Med. 2016 Dec;38(6):1887-1894. doi: 10.3892/ijmm.2016.2776. Epub 2016 Oct 17.
Renal cell carcinoma (RCC) comprises 2‑3% of all malignant tumors in adults. Many studies have established the key roles of smoking, hypertension and other components of metabolic syndrome in the occurrence of RCC. Diabetes mellitus (DM), one of the main consequences of metabolic syndrome, appears much more often in patients with RCC. The prognosis for patients suffering from both diabetes and RCC is worse than for those with kidney cancer only. Diabetes is linked to higher rate of recurrence and a greater number of distant metastases. These factors contribute to a reduction in overall survival (OS) and cause‑specific survival (CSS). Diabetes can also occur as a paraneoplastic syndrome. Tyrosine kinase inhibitors (TKIs), which are agents used in the therapy of metastatic RCC, may have unexpected effects when administered to patients with diabetes. Studies and case reports have shown that they influence blood glucose levels (BGLs) in diabetic patients, sometimes causing dangerous episodes of hypoglycemia. Hyperinsulinemia and hyperglycemia can be considered independent carcinogenic factors, as they increase the amount of pro‑inflammatory cytokines, reactive oxygen species and lipid peroxidation. TKIs have yet to be re‑evaluated as to their safety of use in patients with diabetes.
肾细胞癌（RCC）占成人所有恶性肿瘤的2%-3%。许多研究已证实吸烟、高血压及代谢综合征的其他因素在RCC发生中的关键作用。糖尿病（DM）作为代谢综合征的主要后果之一，在RCC患者中更为常见。糖尿病和RCC患者的预后比单纯肾癌患者更差。糖尿病与更高的复发率和更多的远处转移相关。这些因素导致总生存期（OS）和疾病特异性生存期（CSS）缩短。糖尿病也可作为副肿瘤综合征出现。酪氨酸激酶抑制剂（TKIs）是用于治疗转移性RCC的药物，应用于糖尿病患者时可能产生意想不到的效果。研究和病例报告表明，它们会影响糖尿病患者的血糖水平（BGLs），有时会引发危险的低血糖发作。高胰岛素血症和高血糖可被视为独立的致癌因素，因为它们会增加促炎细胞因子、活性氧和脂质过氧化的量。TKIs在糖尿病患者中的使用安全性尚有待重新评估。
