结直肠癌和高脂饮食关系的研究进展及其防治对策

doi:10.3969/j.issn.1674-8115.2021.11.017

摘要/Abstract

摘要：

结直肠癌（colorectal cancer，CRC）是世界范围内五大恶性肿瘤之一，其发病率位居恶性肿瘤第三，死亡率位居第二，严重威胁着人类的生命健康。流行病学研究显示，经济发达国家的CRC发病率显著高于不发达国家，城市的CRC发病率高于农村。处于不同地理环境的人群的CRC发病特点间差异提示，饮食因素给CRC发病率及患者预后带来了较显著的影响。有证据表明，以高脂饮食为代表的西方饮食结构与CRC的发生发展密切相关，且探索高脂饮食在CRC进程中的相关作用机制对预防CRC的发生、改善患者预后十分重要。该文就近年来国内外关于高脂饮食与CRC发生发展的相关作用机制进行概述，并提出对应的预防策略，从精准医学的层面为膳食结构相关研究和CRC的预防、诊断及治疗提供理论参考。

关键词: 饮食因素, 结直肠癌, 高脂饮食, 个体化营养

Abstract:

Colorectal cancer (CRC) is one of the five malignant tumors in the world, with the second incidence rate and the third mortality of malignancy, which seriously threatens human life and health. Epidemiological studies show that the incidence rate of CRC in the economically developed countries is significantly higher than that in the underdeveloped countries, and that in city is higher than that in rural areas. The difference of CRC incidence populations in different geographical environments indicates that dietary factors can significantly affect incidence rate and prognosis of CRC. There is evidence that the western diet structure represented by high-fat diet is closely related to the occurrence and development of CRC, and exploring the related mechanism of high-fat diet in the process of CRC is very important to prevent the occurrence of CRC and improve the prognosis of the patients. This paper summarizes the relevant mechanism between high-fat diet and the occurrence and development of CRC at home and abroad in recent years, and puts forward the corresponding prevention strategies, so as to provide theoretical reference for the diet structure-related research and the prevention, diagnosis and treatment of CRC from the perspective of precision medicine.

Key words: dietary factor, colorectal cancer (CRC), high-fat diet, personalized nutrition

中图分类号:

R735.3

徐文晖, 卞京, 郑磊贞. 结直肠癌和高脂饮食关系的研究进展及其防治对策[J]. 上海交通大学学报(医学版), 2021, 41(11): 1514-1517.

Wen-hui XU, Jing BIAN, Lei-zhen ZHENG. Research progress of the relationship between high-fat diet and colorectal cancer and its prevention and treatment countermeasures[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(11): 1514-1517.

参考文献 33

1	Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
2	Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021[J]. CA Cancer J Clin, 2021, 71(1): 7-33.
3	Akimoto N, Ugai T, Zhong R, et al. Rising incidence of early-onset colorectal cancer: a call to action[J]. Nat Rev Clin Oncol, 2021, 18(4): 230-243.
4	Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies[J]. Nat Rev Gastroenterol Hepatol, 2019, 16(12): 713-732.
5	Veettil SK, Wong TY, Loo YS, et al. Role of diet in colorectal cancer incidence: umbrella review of meta-analyses of prospective observational studies[J]. JAMA Netw Open, 2021, 4(2): e2037341.
6	孙殿钦, 雷林, 蔡颖, 等. 膳食因素与前列腺癌关系的研究进展[J]. 中华肿瘤杂志, 2021, 43(4): 443-448.
7	雷南, 刁一凡, 白慧君, 等. 美国癌症谱变化及其防治策略研究[J]. 中华预防医学杂志, 2019, 53(7): 737-743.
8	Raskov H, Søby JH, Troelsen J, et al. Driver gene mutations and epigenetics in colorectal cancer[J]. Ann Surg, 2020, 271(1): 75-85.
9	Yaghoubi N, Zahedi Avval F, Khazaei M, et al. MicroRNAs as potential investigative and predictive biomarkers in colorectal cancer[J]. Cell Signal, 2021, 80: 109910.
10	Nakamura Y, Taniguchi H, Ikeda M, et al. Clinical utility of circulating tumor DNA sequencing in advanced gastrointestinal cancer: SCRUM-Japan GI-SCREEN and GOZILA studies[J]. Nat Med, 2020, 26(12): 1859-1864.
11	Schatoff EM, Goswami S, Zafra MP, et al. Distinct colorectal cancer-associated APC mutations dictate response to tankyrase inhibition[J]. Cancer Discov, 2019, 9(10): 1358-1371.
12	Zamani M, Hosseini SV, Mokarram P. Epigenetic biomarkers in colorectal cancer: premises and prospects[J]. Biomarkers, 2018, 23(2): 105-114.
13	Rinaldi L, Delle Donne R, Borzacchiello D, et al. The role of compartmentalized signaling pathways in the control of mitochondrial activities in cancer cells[J]. Biochim Biophys Acta Rev Cancer, 2018, 1869(2): 293-302.
14	Gomes SD, Oliveira CS, Azevedo-Silva J, et al. The role of diet related short-chain fatty acids in colorectal cancer metabolism and survival: prevention and therapeutic implications[J]. Curr Med Chem, 2020, 27(24): 4087-4108.
15	Song M, Chan AT, Sun J. Influence of the gut microbiome, diet, and environment on risk of colorectal cancer[J]. Gastroenterology, 2020, 158(2): 322-340.
16	Pushpanathan P, Mathew GS, Selvarajan S, et al. Gut microbiota and its mysteries[J]. Indian J Med Microbiol, 2019, 37(2): 268-277.
17	Mehta RS, Nishihara R, Cao Y, et al. Association of dietary patterns with risk of colorectal cancer subtypes classified by Fusobacterium nucleatum in tumor tissue[J]. JAMA Oncol, 2017, 3(7): 921-927.
18	Sipe LM, Chaib M, Pingili AK, et al. Microbiome, bile acids, and obesity: how microbially modified metabolites shape anti-tumor immunity[J]. Immunol Rev, 2020, 295(1): 220-239.
19	Ringel AE, Drijvers JM, Baker GJ, et al. Obesity shapes metabolism in the tumor microenvironment to suppress anti-tumor immunity[J]. Cell, 2020, 183(7): 1848-1866.e26.
20	Hullings AG, Sinha R, Liao LM, et al. Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort[J]. Am J Clin Nutr, 2020, 112(3): 603-612.
21	Hosseini SA, Zand H, Cheraghpour M. The influence of curcumin on the downregulation of MYC, insulin and IGF-1 receptors: a possible mechanism underlying the anti-growth and anti-migration in chemoresistant colorectal cancer cells[J]. Medicina, 2019, 55(4): 90.
22	杨泽然, 张欣, 马杰, 等. 大肠癌患者肿瘤相关血管中胰岛素受体表达及其与肿瘤组织病理学特征的关系[J]. 浙江大学学报(医学版), 2020, 49(6): 725-731.
23	Saleh R, Sasidharan Nair V, Murshed K, et al. Transcriptome of CD8⁺ tumor-infiltrating T cells: a link between diabetes and colorectal cancer[J]. Cancer Immunol Immunother, 2021, 70(9): 2625-2638.
24	Klement R, Pazienza V. Impact of different types of diet on gut microbiota profiles and cancer prevention and treatment[J]. Medicina, 2019, 55(4): 84.
25	Grosso G, Bella F, Godos J, et al. Possible role of diet in cancer: systematic review and multiple meta-analyses of dietary patterns, lifestyle factors, and cancer risk[J]. Nutr Rev, 2017, 75(6): 405-419.
26	Dinu M, Abbate R, Gensini GF, et al. Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies[J]. Crit Rev Food Sci Nutr, 2017, 57(17): 3640-3649.
27	Turner ND, Lloyd SK. Association between red meat consumption and colon cancer: a systematic review of experimental results[J]. Exp Biol Med (Maywood), 2017, 242(8): 813-839.
28	Flemer B, Lynch DB, Brown JM, et al. Tumour-associated and non-tumour-associated microbiota in colorectal cancer[J]. Gut, 2017, 66(4): 633-643.
29	Meng C, Bai C, Brown TD, et al. Human gut microbiota and gastrointestinal cancer[J]. Genomics Proteomics Bioinformatics, 2018, 16(1): 33-49.
30	Serrano D, Pozzi C, Guglietta S, et al. Microbiome as mediator of diet on colorectal cancer risk: the role of vitamin D, markers of inflammation and adipokines[J]. Nutrients, 2021, 13(2): 363.
31	Morales DR, Morris AD. Metformin in cancer treatment and prevention[J]. Annu Rev Med, 2015, 66: 17-29.
32	朱为模. 运动抗癌的过去、现在与未来[J]. 成都体育学院学报, 2021, 47(2): 1-8.
33	Sharara AI, El Mokahal A, Harb AH, et al. Risk prediction rule for advanced neoplasia on screening colonoscopy for average-risk individuals[J]. World J Gastroenterol, 2020, 26(37): 5705-5717.

[1]	徐莹, 褚以忞, 杨大明, 李吉, 张海芹, 彭海霞. 基于差异表达基因组合构建高度微卫星不稳定结直肠癌转移预测模型[J]. 上海交通大学学报(医学版), 2021, 41(9): 1197-1206.
[2]	程盛, 赵益, 王永琛, 黄平. BRAF基因突变对肝切除后的结直肠癌肝转移患者预后影响的meta分析[J]. 上海交通大学学报(医学版), 2021, 41(6): 786-792.
[3]	包汝娟, 陈慧芳, 董宇, 叶幼琼, 苏冰. 基于转录组异常表达构建结直肠癌特征基因预后风险评分模型[J]. 上海交通大学学报(医学版), 2021, 41(3): 285-296.
[4]	屠越华, 王筱金, 王炳顺. 个体化营养示范餐对超重及肥胖孕妇妊娠糖尿病的预防效果[J]. 上海交通大学学报(医学版), 2021, 41(3): 360-365.
[5]	马燕如, 季林华, 童天颖, 严宇青, 沈超琴, 张昕雨, 曹颖颖, 洪洁, 陈豪燕. 基于单细胞RNA测序的结直肠癌预后预测模型的建立和验证[J]. 上海交通大学学报(医学版), 2021, 41(2): 159-165.
[6]	傅中懋, 罗再, 戎泽印, 章建明, 李腾飞, 余志龙, 黄陈. 基于高通量测序的结直肠癌组织中环状RNA功能研究与预后分析[J]. 上海交通大学学报(医学版), 2021, 41(2): 187-195.
[7]	陈智灵, 罗晨, 赵康佳, 沈玲, 胡三莲. 2种镇痛方式在结直肠癌术后应用效果的meta分析[J]. 上海交通大学学报(医学版), 2021, 41(10): 1344-1350.
[8]	郭怡琼，吴琼，吴雅婷，高璐璐，杨建军. 枸杞多糖和有氧运动对大鼠非酒精性脂肪肝的干预效果及其机制研究[J]. 上海交通大学学报（医学版）, 2020, 40(1): 30-.
[9]	严宇青，沈超琴，陈豪燕，洪洁#，王震华#. lnc-MTBP-5在结直肠癌中的表达及其对细胞侵袭能力的影响[J]. 上海交通大学学报(医学版), 2020, 40(09): 1193-1201.
[10]	张昕恬，陈锦南，王奇雯，李晓波. 程序性细胞死亡蛋白 1配体 2在激光共聚焦显微内镜诊断结直肠癌中应用的初步探索[J]. 上海交通大学学报（医学版）, 2019, 39(8): 881-.
[11]	孙伟杰 1，徐莹 1，杨静 2，褚以忞 1，杨大明 1，李吉 1，彭海霞 1. 散发性结直肠癌 DNA错配修复系统蛋白表达及其临床意义[J]. 上海交通大学学报（医学版）, 2019, 39(7): 759-.
[12]	王笑 1, 2，所世腾 1，朱炯 1，冯琦 1，华小兰 1，王伟中 2，龚建中 2，刘钧 1，路青 1. 肠道CT图像纹理分析和非线性判别分析在结直肠癌及溃疡性结肠炎判别诊断中的应用[J]. 上海交通大学学报（医学版）, 2018, 38(6): 624-.
[13]	侯悦，李少波，师晓琴，傅国辉，伍均. 结直肠癌KRAS 、NRAS 和BRAF 基因突变与临床病理特征的回顾性分析[J]. 上海交通大学学报（医学版）, 2018, 38(1): 4-.
[14]	沈超琴严婷婷陈豪燕房静远洪洁. SPARC在结直肠癌中的表达及其对细胞侵袭能力影响的机制[J]. 上海交通大学学报（医学版）, 2016, 36(08): 1127-.
[15]	张生军，刘敏丽，常琦，刘勇峰. 姜黄素通过靶向PBK对结直肠癌HCT116细胞增殖的抑制作用[J]. 上海交通大学学报（医学版）, 2016, 36(07): 980-.