Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland.
Department of Urology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland.
Int J Mol Sci. 2020 Sep 30;21(19):7246. doi: 10.3390/ijms21197246.
An increasing number of evidence indicates that metabolic factors may play an important role in the development and progression of certain types of cancers, including renal cell carcinoma (RCC). This tumour is the most common kidney cancer which accounts for approximately 3-5% of malignant tumours in adults. Numerous studies indicated that concomitant diseases, including diabetes mellitus (DM) and hypertension, as well as obesity, insulin resistance, and lipid disorders, may also influence the prognosis and cancer-specific overall survival. However, the results of studies concerning the impact of metabolic factors on RCC are controversial. It appears that obesity increases the risk of RCC development; however, it may be a favourable factor in terms of prognosis. Obesity is closely related to insulin resistance and the development of diabetes mellitus type 2 (DM2T) since the adipocytes in visceral tissue secrete substances responsible for insulin resistance, e.g., free fatty acids. Interactions between insulin and insulin-like growth factor (IGF) system appear to be of key importance in the development and progression of RCC; however, the exact role of insulin and IGFs in RCC pathophysiology remains elusive. Studies indicated that diabetes increased the risk of RCC, but it might not alter cancer-related survival. The risk associated with a lipid profile is most mysterious, as numerous studies provided conflicting results. Even though large studies unravelling pathomechanisms involved in cancer growth are required to finally establish the impact of metabolic factors on the development, progression, and prognosis of renal cancers, it seems that the monitoring of health conditions, such as diabetes, low body mass index (BMI), and lipid disorders is of high importance in clear-cell RCC.
越来越多的证据表明，代谢因素可能在某些类型癌症的发展和进展中发挥重要作用，包括肾细胞癌（RCC）。这种肿瘤是最常见的肾癌，约占成人恶性肿瘤的 3-5%。许多研究表明，伴发疾病，如糖尿病（DM）和高血压，以及肥胖、胰岛素抵抗和脂质紊乱，也可能影响预后和癌症特异性总生存期。然而，关于代谢因素对 RCC 影响的研究结果存在争议。肥胖似乎会增加 RCC 发展的风险；然而，就预后而言，它可能是一个有利因素。肥胖与胰岛素抵抗和 2 型糖尿病（DM2T）的发展密切相关，因为内脏组织中的脂肪细胞分泌导致胰岛素抵抗的物质，如游离脂肪酸。胰岛素和胰岛素样生长因子（IGF）系统之间的相互作用似乎在 RCC 的发展和进展中具有重要意义；然而，胰岛素和 IGFs 在 RCC 病理生理学中的确切作用仍不清楚。研究表明，糖尿病会增加 RCC 的风险，但它可能不会改变与癌症相关的生存。脂质谱相关的风险最为神秘，因为许多研究提供了相互矛盾的结果。尽管需要进行大规模的研究来阐明涉及癌症生长的发病机制，以最终确定代谢因素对肾癌的发展、进展和预后的影响，但似乎监测健康状况，如糖尿病、低体重指数（BMI）和脂质紊乱，对于 clear-cell RCC 非常重要。
