Growth hormone and gastrointestinal malignancy:An intriguing link  

作　　者：Rajan Palui Kalyani Sridharan Sadishkumar Kamalanathan Jayaprakash Sahoo Dukhabandhu Naik 

机构地区：[1]Department of Endocrinology,The Mission Hospital,Durgapur 713212,West Bengal,India [2]Department of Endocrinology,All India Institute of Medical Science,Rishikesh 249203,Uttarakhand,India [3]Department of Endocrinology,Jawaharlal Institute of Postgraduate Medical Education and Research,Puducherry 605006,India

出　　处：《World Journal of Gastrointestinal Pathophysiology》2023年第1期1-11,共11页世界胃肠病理生理学杂志（英文版）（电子版）

摘　　要：Growth hormone(GH)excess is associated with several systemic complications,one of which is the increased risk of neoplastic processes particularly of the gastrointestinal(GI)tract.Among the GI neoplasms,the most reported association is with benign and malignant neoplasms of the colon.In the majority of published literature,an increased incidence of GI neoplasms,both colonic adenomas as well as colorectal carcinoma is reported.However,the studies on colon cancer-specific mortality rate are conflicting with recent studies reporting similar cancer-specific mortality rates in comparison to controls.Many studies have reported an association of colorectal neoplasms with GH levels.Pathogenic mechanisms put forward to explain this association of GH excess and GI neoplasms primarily involve the increased GH-insulin-like growth factor 1(IGF-1)signaling.Both GH and IGF-1 have proliferative,anti-apoptotic,and angiogenic effects on the systemic tissues leading to cellular proliferation.Other contributing factors to the increased risk of GI neoplasms include slow intestinal transit with a redundant large bowel,altered bile acids,deranged local immune response,shared genetic susceptibility factors and hyperinsulinemia.In view of the increased risk association,most guidelines for the care of acromegaly patients recommend an initial screening colonoscopy.Recommendations for further follow-up colonoscopy differ but broadly,the guidelines agree that it depends on the findings at first colonoscopy and state of remission of GH excess.Regarding the concern about the risk of colorectal cancers in patients receiving recombinant GH therapy,most cohort studies do not show an increased risk.

关 键 词：ACROMEGALY COLONOSCOPY Colorectal carcinoma Recombinant growth hormone 

分 类 号：R735.2[医药卫生—肿瘤]