Papaefthymiou Apostolis, Christodoulidis Gregory, Koffas Apostolos, Doulberis Michael, Polyzos Stergios A, Manolakis Anastasios, Potamianos Spyros, Kapsoritakis Andreas, Kountouras Jannis
Department of Gastroenterology, University Hospital of Larissa, Larissa 41110, Thessaly, Greece.
Department of Surgery, University Hospital of Larissa, Larissa 41110, Thessaly, Greece.
World J Gastrointest Oncol. 2021 Oct 15;13(10):1244-1262. doi: 10.4251/wjgo.v13.i10.1244.
Gastric cancer represents a common and highly fatal malignancy, and thus a pathophysiology-based reconsideration is necessary, given the absence of efficient therapeutic regimens. In this regard, emerging data reveal a significant role of autophagy in gastric oncogenesis, progression, metastasis and chemoresistance. Although autophagy comprises a normal primordial process, ensuring cellular homeostasis under energy depletion and stress conditions, alterations at any stage of the complex regulatory system could stimulate a tumorigenic and promoting cascade. Among others, infection induces a variety of signaling molecules modifying autophagy, during acute infection or after chronic autophagy degeneration. Subsequently, defective autophagy allows malignant transformation and upon cancer establishment, an overactive autophagy is stimulated. This overexpressed autophagy provides energy supplies and resistance mechanisms to gastric cancer cells against hosts defenses and anticancer treatment. This review interprets the implicated autophagic pathways in normal cells and in gastric cancer to illuminate the potential preventive, therapeutic and prognostic benefits of understanding and intervening autophagy.
胃癌是一种常见且致死率很高的恶性肿瘤，鉴于缺乏有效的治疗方案，因此有必要基于病理生理学进行重新思考。在这方面，新出现的数据显示自噬在胃癌的发生、发展、转移和化疗耐药中起着重要作用。尽管自噬是一个正常的原始过程，可在能量消耗和应激条件下确保细胞内稳态，但复杂调节系统任何阶段的改变都可能引发致癌和促癌级联反应。其中，感染在急性感染期间或慢性自噬退化后会诱导多种修饰自噬的信号分子。随后，有缺陷的自噬会导致恶性转化，而在癌症形成后，会刺激自噬过度活跃。这种过度表达的自噬为胃癌细胞提供能量供应以及对抗宿主防御和抗癌治疗的抵抗机制。本综述解读了正常细胞和胃癌中涉及的自噬途径，以阐明了解和干预自噬在预防、治疗和预后方面的潜在益处。
