URI - Urological Research Institute, Department of Urology, Division of Experimental Oncology, IRCCS Ospedale San Raffaele.
Università Vita-Salute San Raffaele, Milan, Italy.
Curr Opin Urol. 2022 Nov 1;32(6):594-597. doi: 10.1097/MOU.0000000000001041. Epub 2022 Sep 8.
This review aims to report the latest discoveries regarding the relationship between BMI, obesity, and cancer development and treatment.
Obesity and metabolic syndrome relationships with cancer have been deeply investigated in the literature but their association is still debated. Currently, it has been recorded an association between BMI and endometrial, colorectal, gastric, liver, bladder, and prostate cancer. The mechanisms behind this association have also been investigated. It has been hypothesized that chronic inflammation determined by obesity may concur to the development of tumors and that Insulin Resistance may enhance cell proliferation directly or indirectly. Moreover, different studies suggest that the relationship between higher BMI and cancer may include metabolic disturbances comparable to those linked to metabolic syndrome. However, greater weight has been linked to a better overall prognosis in patients with advanced disease, a concept called the obesity paradox. This paradox has been recently investigated in the context of urological malignancies, such as bladder, prostate, and kidney cancer.
Patients' metabolic and morphological status may impact their risk of developing different types of tumors and the response to systemic therapy. However, further research is necessary to better delineate the mechanisms behind these associations and how they could or should affect medical decision.
本综述旨在报告最新发现,即 BMI、肥胖与癌症发展和治疗之间的关系。
肥胖和代谢综合征与癌症的关系在文献中已得到深入研究,但它们的关联仍存在争议。目前,已经记录了 BMI 与子宫内膜癌、结直肠癌、胃癌、肝癌、膀胱癌和前列腺癌之间的关联。这些关联背后的机制也已经被研究。有人假设,肥胖引起的慢性炎症可能会导致肿瘤的发展,而胰岛素抵抗可能会直接或间接增强细胞增殖。此外,不同的研究表明,较高 BMI 与癌症之间的关系可能包括与代谢综合征相关的代谢紊乱。然而,在晚期疾病患者中,更大的体重与更好的整体预后相关,这一概念被称为肥胖悖论。最近,在膀胱癌、前列腺癌和肾癌等泌尿系统恶性肿瘤的背景下,对这一悖论进行了研究。
患者的代谢和形态状况可能会影响他们患上不同类型肿瘤的风险以及对全身治疗的反应。然而,需要进一步的研究来更好地阐明这些关联背后的机制,以及它们如何或应该影响医学决策。