Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Department of Upper Abdominal Diseases, Cancer Theme, Karolinska University Hospital, Stockholm, Sweden.
Br J Cancer. 2021 May;124(10):1623-1636. doi: 10.1038/s41416-021-01301-4. Epub 2021 Mar 19.
Cancer cachexia is a multifactorial syndrome that is characterised by a loss of skeletal muscle mass, is commonly associated with adipose tissue wasting and malaise, and responds poorly to therapeutic interventions. Although cachexia can affect patients who are severely ill with various malignant or non-malignant conditions, it is particularly common among patients with pancreatic cancer. Pancreatic cancer often leads to the development of cachexia through a combination of distinct factors, which, together, explain its high prevalence and clinical importance in this disease: systemic factors, including metabolic changes and pathogenic signals related to the tumour biology of pancreatic adenocarcinoma; factors resulting from the disruption of the digestive and endocrine functions of the pancreas; and factors related to the close anatomical and functional connection of the pancreas with the gut. In this review, we conceptualise the various insights into the mechanisms underlying pancreatic cancer cachexia according to these three dimensions to expose its particular complexity and the challenges that face clinicians in trying to devise therapeutic interventions.
癌症恶病质是一种多因素综合征，其特征是骨骼肌减少，通常伴有脂肪组织消耗和身体不适，对治疗干预反应不佳。虽然恶病质可影响患有各种恶性或非恶性疾病的重病患者，但在胰腺癌患者中尤为常见。胰腺癌常通过多种不同的因素导致恶病质的发生，这些因素共同解释了其在这种疾病中的高患病率和临床重要性：全身因素，包括与胰腺腺癌肿瘤生物学相关的代谢变化和致病信号；胰腺消化和内分泌功能紊乱导致的因素；以及与胰腺与肠道的紧密解剖和功能联系相关的因素。在这篇综述中，我们根据这三个方面来阐述导致胰腺癌恶病质的各种机制的见解，以揭示其独特的复杂性和临床医生在试图设计治疗干预措施时所面临的挑战。
