2型糖尿病与乳腺癌关系的研究进展

Progression of the association between type 2 diabetes mellitus and breast cancer

目的:总结国内外关于2型糖尿病与乳腺癌关系方面的研究进展。方法:应用PubMed和CNKI期刊全文数据库检索系统,以"2型糖尿病、乳腺癌"为关键词,检索2006-01-2012-10的有关文献。纳入标准:1)关于2型糖尿病和乳腺癌的流行病学文献;2)关于2型糖尿病和乳腺癌相关的基础研究和临床研究文献。根据纳入标准,符合分析的文献51篇。结果:2型糖尿病增加乳腺癌的发病和总死亡风险,在绝经后期女性中尤为显著。2型糖尿病与乳腺癌通过高血糖、高胰岛素血症、胰岛素样生长因子、脂肪细胞因子及内源性性激素等机制发生联系。这些机制在分子水平上相互联系,针对这些机制中某些靶点的抑制剂或单克隆抗体在基础实验和(或)临床试验中取得一定程度的进展。结论:2型糖尿病和乳腺癌相关的具体机制需要更多的基础研究和大型前瞻性临床试验来揭示,这些抑制剂或单克隆抗体有望为难治性乳腺癌提供新的选择,更有利于乳腺癌的个体化治疗。

OBJECTIVE： To summarize the recent advances about the association between type-2 diabetes mellitus and breast cancer. METHODS： The PubMed and CNKI database from Jan 2006 to Oct 2012 was filtered by using the search terms ＂diabetes mellitus.breast cancer＂. Inclusion criterion： 1. Newest epidemiologieal literature about type-2 dia bores mcllitus and breast cancer. 2. Latest or most valuable laboratory and clinical database regard to type-2 diabetes mel- litus and breast cancer. Totally 51 literatures were enrolled in the study according to the criterions. RESULTS：Type-2 di- abetes mellitus is a risk factor of breast cancer and increased its all-cause mortality,especially in postmenopausal women. Tbc association between type-2 diabetes mellitus and breast cancer may refer to some factors,such as hyperglycemia,hy- perinsulinemia,insulin-like growth factor,adipocytokines, endogenous sex hormone and so on. They are interelated in the molecular level. The resear ehes about the inhibitors and monoclonal antibodies in the above-mentioned mechanisms have achieved some improvements in laboratory and clinical studies. CONCLUSIONS： More laboratory studies and large pro- spective clinical trials are needed to provide powerful evidence to clarify detailed mechanism between type-2 diabetes melli- tus and breast cancer. Discoverable inhibitors and monoelonal antibodies may provide new choices to the refractory breast cancer patients and are helpful for individualized treatment.