糖脂代谢异常与口腔鳞癌  

Abnormal glucose and lipid metabolism and oral squamous cell carcinoma

作　　者：王安训[1] WANG Anxun(Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院口腔颌面外科,广东广州510080

出　　处：《口腔疾病防治》2019年第3期137-142,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81672659);广州市科创委产学研协同创新重大专项民生科技研究项目(201605131226218)

摘　　要：流行病学研究显示糖、脂代谢异常与多种恶性肿瘤相关,包括口腔鳞癌。为此本文根据课题组的研究成果结合文献,对糖、脂代谢异常,尤其是糖尿病及肥胖症,在口腔鳞癌发生发展中的作用及其相关发病机制进行述评。糖尿病的高糖血症和高胰岛素血症是增加患癌风险的主要机制,本课题组研究显示,高血糖可通过糖酵解酶M2型丙酮酸激酶(M2 pyruvate kinase,PKM2)、已糖激酶2(Hexokinase 2,HK2)促进舌鳞癌的增殖和侵袭转移;而高胰岛素血症则可通过激活胰岛素样生长因子信号转导系统促进舌鳞癌的增殖和侵袭转移。肥胖症患者常伴有血清脂肪因子Chemerin(Chem)浓度的升高,本课题组研究显示,肥胖症的舌鳞癌患者血清Chem浓度显著高于非肥胖症舌鳞癌患者,Chem可通过SOD2-H2O2信号通路调控舌鳞癌细胞的增殖侵袭迁移能力。上述研究成果为口腔鳞癌的预防提供了依据,为口腔鳞癌的精准治疗提供新的思路,提示治疗口腔鳞癌的同时也应该积极治疗患者的糖尿病及肥胖症等疾病。Epidemiological studies have shown that abnormal glucose and lipid metabolism is associated with a variety of malignant tumors,including oral squamous cell carcinoma.In this paper,the role of abnormal glucose and lipid metabolism,especially diabetes mellitus and obesity,in the occurrence and development of oral squamous cell carcinoma and its pathogenesis are reviewed based on the research results of our group and the literature.Hyperglycemia and insulinemia in diabetes mellitus are the main mechanisms that increase the risk of cancer.Our research shows that hyperglycemia can promote the proliferation,invasion and metastasis of tongue squamous cell carcinoma through the glycolytic enzyme M2 pyruvate kinase(PKM2)and hexokinase 2(HK2).Hyperinsulinemia can promote the proliferation,invasion and metastasis of tongue squamous cell carcinoma by activating the insulin-like growth factor signal transduction system.Obese patients are often accompanied by increased serum adipokine Chemerin(Chem).Our study shows that serum Chem concentrations in obese patients with tongue cancer are significantly higher compared with nonobese patients.Chem can regulate the proliferation,invasion and migration of tongue squamous cell carcinoma cells through the SOD2-H2O2 signaling pathway.These results provide a basis for the prevention of oral squamous cell carcinoma,provide a new iqdea for the precise treatment of oral squamous cell carcinoma,and suggest that the treatment of oral squamous cell carcinoma should also actively treat patients with diabetes and obesity.

关 键 词：糖尿病 肥胖症 代谢性疾病 口腔鳞癌 增殖 侵袭 糖代谢 脂代谢 

分 类 号：R739.8[医药卫生—肿瘤]