Nguyen Lily, Shanmugan Skandan
Department of Surgery, Division of Colon and Rectal Surgery, University of California, 333 The City Blvd West, Suite 1600, Suite 1600, Irvine, CA, USA, 92868-3298.
Curr Diab Rep. 2024 Dec 2;25(1):8. doi: 10.1007/s11892-024-01556-0.
This article aims to review the recent literature assessing the relationship between obesity and colorectal carcinogenesis, the effect of obesity on the treatment of colorectal cancer (CRC), tools available to help augment the increased risk, and outcomes for patients who are affected by both obesity and colorectal cancer.
The biochemical mechanisms contributing to CRC carcinogenesis are not well understood but are suspected to be related to adipose tissue leading to a pro-inflammatory state and changes in the gut microbiome. Individuals with obesity are at higher risk for CRC development, worse oncologic outcomes, and increased rates of post-operative complications. Bariatric surgery decreases CRC risk but results with GLP-1 agonists are heterogeneous. Prehabilitation is the only weight loss method that has been demonstrated to decrease risks of post-operative morbidity in this population. Obesity augments CRC risk and outcomes. There are persistent knowledge gaps in etiology and epidemiology for the increased CRC risk in obese patients and more research is required to identify the therapeutic advantage of weight loss on CRC risk.
本文旨在回顾近期评估肥胖与结直肠癌发生之间关系、肥胖对结直肠癌（CRC）治疗效果的影响、有助于降低增加风险的可用工具以及肥胖合并结直肠癌患者预后的文献。
导致结直肠癌发生的生化机制尚未完全明确，但怀疑与脂肪组织导致的促炎状态和肠道微生物群变化有关。肥胖个体患结直肠癌的风险更高，肿瘤学预后更差，术后并发症发生率增加。减肥手术可降低结直肠癌风险，但胰高血糖素样肽-1（GLP-1）激动剂的效果不一。术前康复是唯一已被证明可降低该人群术后发病风险的减肥方法。肥胖会增加结直肠癌风险并影响预后。肥胖患者结直肠癌风险增加的病因学和流行病学方面仍存在知识空白，需要更多研究来确定减肥对结直肠癌风险的治疗优势。
