Evans Megan A, Walsh Kenneth
Division of Cardiovascular Medicine, Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Division of Cardiovascular Medicine, Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
JACC CardioOncol. 2025 Aug;7(5):470-495. doi: 10.1016/j.jaccao.2025.06.006.
Emerging evidence suggests a dynamic relationship exists between cancer and cardiovascular disease (CVD). CVD is common among cancer survivors; however, it also may increase the risk of developing cancer. The underlying factors driving this connection remain poorly understood. Aging, chronic inflammation, and perturbed immune signaling are shared hallmarks of cancer and CVD. Clonal hematopoiesis (CH), the age-related accumulation of somatic mutations in hematopoietic cells leading to cells with a growth advantage, is associated with immune dysregulation in elderly people. Growing evidence suggests that CH is a risk factor for CVD. Although the link between CH and hematological cancer is well established, its relationship to solid organ cancers is far less understood. This review provides an in-depth analysis of the evidence linking CH with solid organ malignancies and explores its role as a shared risk factor for the development of both CVD and cancer. Furthermore, it discusses the potential mechanisms by which CH may contribute to CVD among cancer survivors.
新出现的证据表明，癌症与心血管疾病（CVD）之间存在动态关系。CVD在癌症幸存者中很常见；然而，它也可能增加患癌风险。导致这种联系的潜在因素仍知之甚少。衰老、慢性炎症和免疫信号紊乱是癌症和CVD的共同特征。克隆性造血（CH）是造血细胞中与年龄相关的体细胞突变积累，导致具有生长优势的细胞，与老年人的免疫失调有关。越来越多的证据表明，CH是CVD的一个危险因素。虽然CH与血液系统癌症之间的联系已得到充分证实，但其与实体器官癌症的关系却知之甚少。本综述对将CH与实体器官恶性肿瘤联系起来的证据进行了深入分析，并探讨了其作为CVD和癌症发展的共同危险因素的作用。此外，还讨论了CH可能导致癌症幸存者发生CVD的潜在机制。
