流行病学:炎症与肿瘤的关系

2015-02-28 梁军 孙丽斌 中国医学论坛报

肿瘤组织中存在免疫细胞浸润 炎症与肿瘤的关系最早引起研究者的关注,是因为人们在肿瘤的标本中发现了免疫细胞浸润。当时这个现象大多被解释成为机体免疫系统对肿瘤细胞的应答,但是德国的菲尔绍(Virchow)教授却提出了不同意见,认为“肿瘤起源于慢性炎症”。此外,在肿瘤中发现的免疫细胞类型与非肿瘤性炎症部位的细胞一致,因此当时病理学家将肿瘤称为“永不愈合的创伤”。此后越来越多的科学家深入研究肿瘤与炎症的

肿瘤组织中存在免疫细胞浸润

炎症与肿瘤的关系最早引起研究者的关注,是因为人们在肿瘤的标本中发现了免疫细胞浸润。当时这个现象大多被解释成为机体免疫系统对肿瘤细胞的应答,但是德国的菲尔绍(Virchow)教授却提出了不同意见,认为“肿瘤起源于慢性炎症”。此外,在肿瘤中发现的免疫细胞类型与非肿瘤性炎症部位的细胞一致,因此当时病理学家将肿瘤称为“永不愈合的创伤”。此后越来越多的科学家深入研究肿瘤与炎症的关系,发现慢性炎症是许多恶性肿瘤发生的高危因素,参与恶变、肿瘤形成、发展、侵袭、转移等多个过程,被列为肿瘤细胞十大生物学特征之一。

与慢性炎症相关的肿瘤

研究显示,20%以上肿瘤由感染导致的慢性炎症诱发。常见与肿瘤相关的感染性慢性炎症包括慢性肝炎病毒与肝癌、人乳头状瘤病毒(HPV)与宫颈癌、幽门螺杆菌与胃癌及黏膜相关性淋巴瘤、人疱疹病毒4型(EBV)与鼻咽癌、华支睾吸虫与胆管癌等(如下表)。

表2002年在发达国家和发展中国家中归因于感染的癌症统计数据

注:HBV为乙型肝炎病毒;HCV为丙型肝炎病毒;HIV为人类免疫缺陷病毒;EBV为人类疱疹病毒4型,B.L.为伯基特淋巴瘤;HHV8为人类疱疹病毒8型;HTLV-1为人类T淋巴细胞白血病病毒1型;数据来源于《国际癌症杂志》

当然,感染并非慢性炎症唯一原因,紫外线、肥胖、烟草等这些非感染性慢性炎症也是诱发肿瘤的因素,如吸烟与肺癌高度相关。还有一些是由于自身免疫异常导致的慢性炎症而诱发的肿瘤,如炎性肠病与大肠癌、慢性胰腺炎与胰腺癌、前列腺炎与前列腺癌等。

另外,也并非所有慢性炎症均是肿瘤的诱发因素。例如:幽门螺杆菌可增加胃癌的患病风险,但对食管和贲门腺癌,幽门螺杆菌却有保护性作用,而且,即使是针对胃癌,幽门螺杆菌的致癌作用也仅仅表现在亚洲人群中,在其他幽门螺杆菌的高发地区,并未发现与胃癌的相关性;风湿性关节炎、银屑病都是免疫性炎症疾病,但是与同是免疫性炎症的炎性肠病不同,这两者并无促肿瘤生长的作用。相反,银屑病的患者具有皮肤癌发生率降低的趋势。

慢性炎症对不同种族或不同器官的作用差异产生的机理至今还不为人知,尚有待进一步的研究。

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    2015-05-16 ljjj1053

    很不错学习了

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=23731, encodeId=cccd23e31c0, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:52:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23709, encodeId=2cfa23e096b, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:32:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411228, encodeId=95e6141122853, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 02 01:01:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17327, encodeId=80a61e327e8, content=肯定是有关的, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=11a91616246, createdName=CRAZYDAFF, createdTime=Sun Mar 01 23:20:00 CST 2015, time=2015-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17267, encodeId=046f1e267c7, content=炎症与癌症是剪不断,理还乱, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Feb 28 19:53:00 CST 2015, time=2015-02-28, status=1, ipAttribution=)]
    2015-05-16 ljjj1053

    很不错学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=23731, encodeId=cccd23e31c0, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:52:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23709, encodeId=2cfa23e096b, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:32:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411228, encodeId=95e6141122853, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 02 01:01:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17327, encodeId=80a61e327e8, content=肯定是有关的, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=11a91616246, createdName=CRAZYDAFF, createdTime=Sun Mar 01 23:20:00 CST 2015, time=2015-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17267, encodeId=046f1e267c7, content=炎症与癌症是剪不断,理还乱, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Feb 28 19:53:00 CST 2015, time=2015-02-28, status=1, ipAttribution=)]
    2015-03-02 xugumin
  4. [GetPortalCommentsPageByObjectIdResponse(id=23731, encodeId=cccd23e31c0, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:52:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23709, encodeId=2cfa23e096b, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:32:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411228, encodeId=95e6141122853, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 02 01:01:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17327, encodeId=80a61e327e8, content=肯定是有关的, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=11a91616246, createdName=CRAZYDAFF, createdTime=Sun Mar 01 23:20:00 CST 2015, time=2015-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17267, encodeId=046f1e267c7, content=炎症与癌症是剪不断,理还乱, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Feb 28 19:53:00 CST 2015, time=2015-02-28, status=1, ipAttribution=)]
    2015-03-01 CRAZYDAFF

    肯定是有关的

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=23731, encodeId=cccd23e31c0, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:52:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=23709, encodeId=2cfa23e096b, content=很不错学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Sat May 16 19:32:00 CST 2015, time=2015-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1411228, encodeId=95e6141122853, content=<a href='/topic/show?id=91e96538eee' target=_blank style='color:#2F92EE;'>#流行病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65387, encryptionId=91e96538eee, topicName=流行病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 02 01:01:00 CST 2015, time=2015-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17327, encodeId=80a61e327e8, content=肯定是有关的, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=11a91616246, createdName=CRAZYDAFF, createdTime=Sun Mar 01 23:20:00 CST 2015, time=2015-03-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17267, encodeId=046f1e267c7, content=炎症与癌症是剪不断,理还乱, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Feb 28 19:53:00 CST 2015, time=2015-02-28, status=1, ipAttribution=)]
    2015-02-28 medcardio

    炎症与癌症是剪不断,理还乱

    0