铁蛋白为肿瘤诊治提供新的视角

Ferritin provided a new perspective for tumor diagnosis and treatment

铁既是生命所必须,又与肿瘤的发生、发展密切相关。铁在氧化态和还原态之间循环导致自由基形成,由此产生包括肿瘤形成在内的有害作用。异常铁代谢增加肿瘤发病风险,促进肿瘤的生长。铁蛋白是一种由肝脏合成的糖蛋白,在铁的平衡中起至关重要的作用。铁蛋白通过将铁摄入并贮存,避免了细胞内高浓度游离铁对细胞的毒性作用。血清铁蛋白是反映体内铁储备的主要指标,大多数肿瘤患者中铁蛋白的表达增加。铁蛋白通过参与抗氧化损伤、血管生成、免疫抑制、促进细胞增殖等促进肿瘤的发生、发展。高表达铁蛋白的患者生存期短,提示其可作为评估肿瘤预后的指标。下调铁蛋白的表达不仅能够抑制肿瘤增殖,还能增加化疗药物的敏感性,提示其在抗肿瘤治疗中的潜在前景。许多新发现让我们重新认识铁蛋白,但是仍需要更深入的研究来继续揭示铁蛋白的新功能。本文拟通过阐述铁蛋白促进肿瘤增殖机制的最新研究及其与肿瘤预后的相关性,对铁蛋白在抗肿瘤治疗中的临床意义以及进一步应用进行综述。

Iron, as necessary trace element in the human body, was associated with tumorigenesis and development. The free radicals coming from the process of oxidation and reduction cycle of iron, caused harmful effects, such as tumorigenesis. Besides, abnormal iron metabolism increased the risk of tumorigenesis and promotes tumor growth. Ferritin, a glycoprotein synthesized by the liver, played an important role in the balance of iron metabolism. Combined with the free iron, ferritin prevented from toxic effects of high intracellular concentration of free iron. Serum ferritin was a main indicator of iron storage in the body, and the expression levels of ferritin are increased in majority patients with cancer. Furthermore, ferritin was also involved in tumorigenesis and development by anti-oxidative damage, angiogenesis, immunosuppression and promoting cell proliferation. The survival of patients with high expression of ferritin was worse, suggesting that it could be used as prognostic indicator of cancer patients. On the other hand, the down-regulated expression of ferritin could not only inhibit the proliferation of cancer cells, but also increased their sensitivity to chemotherapy. It was implicated that ferritin may have potential in treatment of cancer. Although many new fndings have led to a further understanding of ferritin, further research is needed to shed new light on the role of ferritin. In this review, we aim to provide an overview about the clinical significance of ferritin and its further application in the treatment of cancer, based on the recent advances in tumorigenesis mechanism of ferritin, and the studies of correlation between its expression and prognosis.