恶性肿瘤糖代谢与放射治疗关系的研究进展

Radiotherapy and glucose metabolism of malignant tumors

恶性肿瘤代谢方面研究表明,恶性肿瘤细胞具有重新编程能量代谢的能力,包括有氧糖酵解、谷氨酰胺代谢紊乱,脂质合成和氧化发生改变等,恶性肿瘤细胞的异常能量代谢能够导致恶性肿瘤细胞如迅速增殖、抗凋亡、干细胞样特征、上皮-间充质转化、转移、血管新生、免疫逃逸、耐放化疗等。Warburg效应是恶性肿瘤重新编程能量代谢的重要表现,并在肿瘤的生长、转移、复发中占有重要地位。放射治疗是肿瘤综合治疗的重要组成部分,60%~70%的恶性肿瘤患者在整个治疗过程中需要接受放射治疗,并且放射治疗对肿瘤治愈贡献比达到40%以上,其机制主要为通过自由基诱导的DNA损伤来杀死肿瘤细胞。恶性肿瘤细胞的有氧糖酵解与肿瘤放疗抵抗密切相关,研究发现这些有氧糖酵解途径的产物,构成了恶性肿瘤细胞内的氧化还原缓冲液网络,有效地清除了自由基和活性氧,从而削弱了放射治疗的疗效。因而抑制恶性肿瘤细胞的糖代谢可能会促进其放疗敏感性,改善患者放射治疗疗效,改善生存期,降低死亡率。

Malignant tumor metabolism studies have shown that malignant cells have the ability to reprogram energymetabolism, including aerobic glycolysis, glutamine metabolic disorders, lipid synthesis and oxidative changes, abnormal energymetabolism of malignant cells can cause malignancy. Tumor cells such as rapid proliferation, anti-apoptotic, stem cell-like features,epithelial-mesenchymal transition, metastasis, angiogenesis, immune escape, radiotherapy and chemotherapy. Warburg effect isan important manifestation of malignant tumor reprogramming energy metabolism and plays an important role in tumor growth,metastasis and recurrence. Radiation therapy is an important part of comprehensive cancer treatment. 60%~70% of patients withmalignant tumors need to receive radiation therapy throughout the course of treatment, and the contribution of radiation therapyto tumor healing is more than 40%. The mechanism is mainly through free radicals Induced DNA damage to kill tumor cells. Theaerobic glycolysis of malignant cells is closely related to the resistance to tumor radiotherapy and the product of these aerobicglycolysis pathways has been found to form a network of redox buffers in malignant cells that effectively removes free radicals andreactive oxygen species , Thus undermining the efficacy of radiation therapy. Thus inhibition of glucose metabolism in malignantcells may promote its radiosensitivity, improve the efficacy of radiation therapy in patients, improve survival and reduce mortality.