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类癌心脏病的分子生物学:在靶向治疗时代寻找治疗靶点。

Molecular biology of carcinoid heart disease: Seeking therapeutic targets in the era of targeted therapy.

机构信息

Birat Medical College Teaching Hospital, Morang, Nepal.

Department of Anesthesiology and Critical Care, Birat Medical College Teaching Hospital, Morang, Nepal.

出版信息

Medicine (Baltimore). 2023 Nov 24;102(47):e36043. doi: 10.1097/MD.0000000000036043.

Abstract

Carcinoid tumors (CT) are among the least studied tumors. It is a relatively rare and slow-growing tumor with good survival in its primary form. However, metastatic carcinoid tumor comes up with many different complications contributing to increased morbidity and mortality. Metastatic form of the disease has a wide spectrum of clinical manifestations and multisystem involvement including cardiovascular manifestations, neurological manifestations, and psychiatric manifestations and so on. In this review, we are centered towards the cardiovascular manifestations of the disease, which, by far, is one of the commonest causes of death in these patients. Being a neuroendocrine tumor, cardiovascular manifestations are mainly because of biologically active substances, produced by the tumor cells, remodeling the heart. Development of targeted therapies against carcinoid heart diseases is currently limited by lack of understanding of pathophysiology of the disease processes. In this review, we aim to figure out the spectrum of carcinoid heart diseases, along with the molecular biology of the changes going on, which, in turn, will not only pave a way to the development of targeted therapies but will also extend opportunities for molecular screening of the tumor and diagnosis at an early stage, thereby, reducing the morbidity and mortality.

摘要

类癌肿瘤(CT)是研究最少的肿瘤之一。它是一种相对罕见且生长缓慢的肿瘤,在原发性肿瘤中具有良好的生存能力。然而,转移性类癌肿瘤会出现许多不同的并发症,导致发病率和死亡率增加。该疾病的转移性形式具有广泛的临床表现和多系统受累,包括心血管表现、神经表现和精神表现等。在这篇综述中,我们主要关注该疾病的心血管表现,这是迄今为止此类患者最常见的死亡原因之一。作为一种神经内分泌肿瘤,心血管表现主要是由于肿瘤细胞产生的生物活性物质重塑心脏所致。针对类癌性心脏病的靶向治疗的发展目前受到对疾病过程病理生理学理解有限的限制。在这篇综述中,我们旨在阐明类癌性心脏病的范围,以及正在发生的分子生物学变化,这不仅将为靶向治疗的发展铺平道路,还将为肿瘤的分子筛查和早期诊断提供机会,从而降低发病率和死亡率。

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