Vladimirova S G, Tarasova L N
Kirov Research Institute of Hematology and Blood Transfusion, Federal Biomedical Agency of Russia, Kirov, Russia.
Ter Arkh. 2016;88(3):116-120. doi: 10.17116/terarkh2015883116-120.
It is considered that hypercholesterolemia is life-threatening and low cholesterol levels are a positive factor. However, taking into consideration the fact that cholesterol plays a key role in cell proliferation, it should be remembered that its low blood level may be linked to high cholesterol demands from neoplastic cells. The literature review analyzes the results of recent investigations of lipid metabolism in patients with hematologic cancers and their other types. All given investigations show a significant reduction in the serum levels of total cholesterol and high-density lipoproteins in patients with hematological disease at its onset. The data for other indicators of the lipid transport system are ambiguous. Such changes have been elucidated to be associated with the accumulation of cholesterol in the leukemia cells due to enhanced synthesis de novo, a more active absorption from circulation and blocked release of its surplus. If the disease runs a favorable course, lipid metabolic parameters become normalized and, in case of remission, correspond to those seen in healthy individuals. They continue to decline in patients with disease progression. This allows the consideration of cholesterol, its fractions, and apolipoproteins as biochemical prognostic markers in hematological cancer patients and as indicators for assessment of treatment results. In addition, there is evidence for the effect of chemotherapeutic agents on lipid metabolism. Recent attempts to elaborate new treatment strategies, by using the current knowledge on the role of lipid metabolism in cancers, are considered.
人们认为高胆固醇血症会危及生命，而低胆固醇水平是一个积极因素。然而，考虑到胆固醇在细胞增殖中起关键作用，应该记住，血液中胆固醇水平低可能与肿瘤细胞对胆固醇的高需求有关。文献综述分析了近期对血液系统癌症患者及其他类型癌症患者脂质代谢的研究结果。所有这些研究均表明，血液系统疾病发病时患者的血清总胆固醇和高密度脂蛋白水平显著降低。脂质转运系统其他指标的数据并不明确。已阐明这种变化与白血病细胞中胆固醇的积累有关，这是由于从头合成增强、从循环中更活跃的吸收以及其多余部分的释放受阻。如果疾病进展顺利，脂质代谢参数会恢复正常，在缓解期则与健康个体的参数相当。在疾病进展的患者中，这些参数会持续下降。这使得胆固醇及其组分和载脂蛋白可被视为血液系统癌症患者的生化预后标志物以及评估治疗效果的指标。此外，有证据表明化疗药物对脂质代谢有影响。本文还考虑了利用当前关于脂质代谢在癌症中的作用的知识来制定新治疗策略的最新尝试。
