Lan Qinghai, Ouyang Aiping, Chen Yijian, Li Youchun, Zhong Baolin, Deng Simin
Department of Anesthesiology, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
Front Oncol. 2025 Mar 17;15:1534300. doi: 10.3389/fonc.2025.1534300. eCollection 2025.
Patients with advanced cancer frequently endure severe pain, which substantially diminishes their quality of life and can adversely impact survival. Analgesia, a critical modality for alleviating such pain, is now under scrutiny for its potential role in cancer progression, a relationship whose underlying mechanisms remain obscure. Emerging evidence suggests that lactate, once considered a metabolic byproduct, actively participates in the malignant progression of cancer by modulating both metabolic and immunological pathways within the tumor microenvironment. Furthermore, lactate is implicated in the modulation of cancer-related pain, exerting effects through direct and indirect mechanisms. This review synthesizes current understanding of lactate's production, transport, and functional roles in tumor cells, encompassing the regulation of tumor metabolism, immunity, and progression. Additionally, we dissect the complex, bidirectional relationship between lactate and pain, and assess the impact of anesthetics on pain relief, lactate homeostasis, and tumorigenesis.
晚期癌症患者常常忍受着剧痛，这极大地降低了他们的生活质量，并可能对生存产生不利影响。镇痛作为缓解此类疼痛的关键手段，目前正因其在癌症进展中的潜在作用而受到审视，而这种关系的潜在机制仍不清楚。新出现的证据表明，乳酸盐曾被视为一种代谢副产物，现在通过调节肿瘤微环境中的代谢和免疫途径，积极参与癌症的恶性进展。此外，乳酸盐与癌症相关疼痛的调节有关，通过直接和间接机制发挥作用。本综述综合了目前对乳酸盐在肿瘤细胞中的产生、转运和功能作用的理解，包括对肿瘤代谢、免疫和进展的调节。此外，我们剖析了乳酸盐与疼痛之间复杂的双向关系，并评估了麻醉剂对疼痛缓解、乳酸盐稳态和肿瘤发生的影响。
