代谢综合征与乳腺癌关系的研究进展

Advances in studies on metabolic syndrome and breast cancer

乳腺癌是女性最常见的恶性肿瘤之一。随着经济水平的提高及生活方式的改变，我国代谢综合征（MS）的发病人数也在不断增长，其与乳腺癌的关系也日益引起重视。MS可以增加乳腺癌的发病风险，并且随着异常代谢组分数目的增加，患者罹患乳腺癌的风险呈线性上升趋势。不仅如此，MS及其各组分也与乳腺癌的复发和转移呈现出不同程度的相关性。对于乳腺癌患者来说，MS不仅可以增加其心血管疾病和其他肿瘤的发生率，还能降低其对化疗的反应率。因此，合并MS将增加乳腺癌患者病死率，导致其预后不良。MS中多种交叉关联的代谢和信号转导通路相互作用，直接或间接地影响乳腺癌进展和预后。然而，具体机制并不十分清楚，这可能与胰岛素及胰岛素样生长因子、瘦素、炎性介质等水平升高，脂联素水平降低及乳腺癌缺失基因1和沉默交配类型信息调节2同源物1的相互作用有关。通过调节饮食结构、增加运动及药物干预可以改善合并MS的乳腺癌患者的预后。虽然MS和乳腺癌相互影响的具体机制仍亟待阐明，但深入认识这两者的关系可以帮助我们制定预防和治疗乳腺癌的新策略。

Breast cancer is one of the most common malignancies in women. Over these years, the morbidity of metabolic syndrome （MS） has also been increasing in China, probably due to changes in economies and lifestyles. As a result, the association to between these two diseases has attracted much attention. Results demonstrated the presence of MS was associated with breast cancer risk, and the risk became higher when more MS components were present compared to no components. Moreover, a specific association was indicated between MS and breast cancer recurrence and metastasis to some extent as well. Further, for breast cancer patients, being diagnosed with MS can increase the mortality and lead to poor prognosis. The mechanisms underlying the association is not clear yet, but several factors are speculated to be the possible causes, including the elevated level of insulin, insulin like growth factor-I, leptin and pro- inflammatory cytokines, the decreased level of adiponectin as well as the interaction between DBC1 and SIRT1. The prognosis of patients with breast cancer combined MS can be improved by means of changing diet habits, increasing physical activities and drog-intervention. Although the specific mechanisms underlying the association are still need to be elucidated, better understanding of the association must help us with new strategies for the prevention and treatment of breast cancer.