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Gastrointestinal Malignancy: Genetic Implications to Clinical Applications. 胃肠道恶性肿瘤:遗传学对临床应用的影响。
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-61238-1_15
Hannah E Trembath, Jen Jen Yeh, Nicole E Lopez

Advances in molecular genetics have revolutionized our understanding of the pathogenesis, progression, and therapeutic options for treating gastrointestinal (GI) cancers. This chapter provides a comprehensive overview of the molecular landscape of GI cancers, focusing on key genetic alterations implicated in tumorigenesis across various anatomical sites including GIST, colon and rectum, and pancreas. Emphasis is placed on critical oncogenic pathways, such as mutations in tumor suppressor genes, oncogenes, chromosomal instability, microsatellite instability, and epigenetic modifications. The role of molecular biomarkers in predicting prognosis, guiding treatment decisions, and monitoring therapeutic response is discussed, highlighting the integration of genomic profiling into clinical practice. Finally, we address the evolving landscape of precision oncology in GI cancers, considering targeted therapies and immunotherapies.

分子遗传学的进步彻底改变了我们对胃肠道(GI)癌症的发病机制、进展和治疗方案的认识。本章全面概述了胃肠道癌症的分子状况,重点介绍了与不同解剖部位(包括胃食管腺癌、结肠和直肠癌以及胰腺癌)肿瘤发生有关的关键基因改变。重点是关键的致癌途径,如抑癌基因突变、致癌基因、染色体不稳定性、微卫星不稳定性和表观遗传修饰。我们还讨论了分子生物标志物在预测预后、指导治疗决策和监测治疗反应方面的作用,强调了将基因组剖析融入临床实践的重要性。最后,我们探讨了消化道癌症精准肿瘤学不断发展的前景,并考虑了靶向疗法和免疫疗法。
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引用次数: 0
Gallbladder Cancer. 胆囊癌
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-61238-1_8
Clayton T Marcinak, Daniel E Abbott

Gallbladder carcinoma (GBC) is the most common biliary epithelial malignancy, with an estimated incidence of 1.13 cases per 100,000 in the United States (Hundal and Shaffer in Clin Epidemiol 6:99-109, 2014 1; Henley et al. in Cancer Epidemiol Biomarkers Prev 24:1319-1326, 2015 2). The insidious nature and late presentation of this disease place it among the most lethal invasive neoplasms. Gallbladder cancer spreads early by lymphatic or hematogenous metastasis, as well as by direct invasion into the liver. While surgery may be curative at early stages, both surgical and nonsurgical treatments remain largely unsuccessful in patients with more advanced diseases (Rahman et al. in Cancer Med 6:874-880, 2017 3).

胆囊癌(GBC)是最常见的胆道上皮恶性肿瘤,在美国的发病率估计为每 10 万人 1.13 例(Hundal 和 Shaffer 发表于 Clin Epidemiol 6:99-109, 2014 1;Henley 等人发表于 Cancer Epidemiol Biomarkers Prev 24:1319-1326, 2015 2)。这种疾病的隐匿性和晚期表现使其跻身于最致命的侵袭性肿瘤之列。胆囊癌早期通过淋巴或血行转移以及直接侵入肝脏进行扩散。虽然早期手术可以治愈,但对于晚期患者,手术和非手术治疗在很大程度上仍不成功(Rahman 等,发表于《癌症医学》(Cancer Med)6:874-880,2017 年 3 期)。
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引用次数: 0
Introduction to Nutrition and Cancer. 营养与癌症入门
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-55622-7_1
Hanadi Talal Ahmedah, Haneen Adel Basheer, Inas Almazari, Kawther Faisal Amawi

By the beginning of the year 2021, the estimated number of new cancer cases worldwide was about 19.3 million and there were 10.0 million cancer-related deaths. Cancer is one of the deadliest diseases worldwide that can be attributed to genetic and environmental factors, including nutrition. The good nutrition concept focuses on the dietary requirements to sustain life. There is a substantial amount of evidence suggesting that a healthy diet can modulate cancer risk, particularly the risk of colorectal and breast cancers. Many studies have evaluated the correlation between our diet and the risk of cancer development, prevention, and treatment. The effect of diet on cancer development is likely to happen through intertwining mechanisms including inflammation and immune responses. For instance, a greater intake of red and processed meat along with low consumption of fruits and vegetables has been associated with increased levels of inflammatory biomarkers that are implicated in cancer development. On the other hand, the consumption of phytosterols, vitamins, and minerals, which exert antioxidant and anti-inflammatory roles have been linked to lower cancer risk, or even its occurrence prevention. In this book, we aim to summarize the current knowledge on the role of nutrition in cancer to provide the best scientific advice in this regard.

到 2021 年初,全球新发癌症病例估计约为 1 930 万例,与癌症相关的死亡人数为 1 000 万。癌症是全球最致命的疾病之一,其成因可能与遗传和环境因素(包括营养)有关。良好营养的概念侧重于维持生命所需的饮食。大量证据表明,健康的饮食可以调节患癌风险,尤其是结直肠癌和乳腺癌的风险。许多研究评估了我们的饮食与癌症发病、预防和治疗风险之间的相关性。饮食对癌症发生的影响可能是通过包括炎症和免疫反应在内的交织机制产生的。例如,摄入较多的红肉和加工肉类以及摄入较少的水果和蔬菜与炎症生物标志物水平升高有关,而炎症生物标志物与癌症的发展有牵连。另一方面,食用具有抗氧化和抗炎作用的植物甾醇、维生素和矿物质与降低癌症风险甚至预防癌症发生有关。在本书中,我们旨在总结当前有关营养在癌症中作用的知识,以提供这方面的最佳科学建议。
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引用次数: 0
Understanding the Role of Polyunsaturated Fatty Acids in the Development and Prevention of Cancer. 了解多不饱和脂肪酸在癌症发展和预防中的作用。
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-55622-7_3
Samina Akbar, Abdur Rahman, Nazir Ahmad, Muhammad Imran, Zeeshan Hafeez

Polyunsaturated fatty acids (PUFAs), notably omega-3 (n-3) and omega-6 (n-6), have received much attention owing to their multifaceted effects not only in the management of diverse pathological conditions but also in the maintenance of overall health of an individual. A disproportionately high n-6 to n-3 ratio contributes to the development of various disorders including cancer, which ranks as a leading cause of death worldwide with profound social and economic burden. Epidemiological studies and clinical trials combined with the animal and cell culture models have demonstrated the beneficial effects of n-3 PUFAs in reducing the risk of various cancer types including breast, prostate and colon cancer. The anti-cancer actions of n-3 PUFAs are mainly attributed to their role in the modulation of a wide array of cellular processes including membrane dynamics, apoptosis, inflammation, angiogenesis, oxidative stress, gene expression and signal transduction pathways. On the contrary, n-6 PUFAs have been shown to exert pro-tumor actions; however, the inconsistent findings and controversial data emphasize upon the need to further investigation. Nevertheless, one of the biggest challenges in future is to optimize the n-6 to n-3 ratio despite the genetic predisposition, age, gender and disease severity. Moreover, a better understanding of the potential risks and benefits as well as the cellular and molecular mechanisms of the basic actions of these PUFAs is required to explore their role as adjuvants in cancer therapy. All these aspects will be reviewed in this chapter.

多不饱和脂肪酸(PUFAs),尤其是欧米伽-3(n-3)和欧米伽-6(n-6),因其多方面的作用而备受关注,这些作用不仅体现在对各种病症的治疗上,还体现在对个人整体健康的维护上。n-6 和 n-3 的比例过高会导致包括癌症在内的各种疾病的发生,而癌症是导致全球死亡的主要原因之一,对社会和经济造成了深重的负担。流行病学研究、临床试验以及动物和细胞培养模型都表明,n-3 PUFAs 有助于降低罹患乳腺癌、前列腺癌和结肠癌等各种癌症的风险。n-3 PUFAs 的抗癌作用主要归因于它们在调节一系列细胞过程中的作用,包括膜动力学、细胞凋亡、炎症、血管生成、氧化应激、基因表达和信号转导途径。相反,n-6 PUFAs 被证明具有促肿瘤作用;然而,不一致的研究结果和有争议的数据强调了进一步研究的必要性。尽管如此,未来最大的挑战之一是如何优化 n-6 和 n-3 的比例,而不考虑遗传倾向、年龄、性别和疾病严重程度。此外,还需要更好地了解这些 PUFAs 的潜在风险和益处以及基本作用的细胞和分子机制,以探索它们在癌症治疗中的辅助作用。本章将对所有这些方面进行综述。
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引用次数: 0
Pathologic Features of Miscellaneous Foregut Malignancies. 各种前肠恶性肿瘤的病理特征。
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-61238-1_3
Mark Sharobim, Eduard Matkovic, Michael Schwalbe, Kristina A Matkowskyj

Neuroendocrine neoplasms are a heterogeneous group of tumors that can occur in almost any organ and share a common neuroendocrine phenotype.

神经内分泌肿瘤是一类异质性肿瘤,几乎可发生在任何器官,并具有共同的神经内分泌表型。
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引用次数: 0
Role of Natural Antioxidants in Cancer. 天然抗氧化剂在癌症中的作用。
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-55622-7_4
Faizah Jabr Alsulami, Sadr Ul Shaheed

The oxidative stress defined as an event caused by an imbalance between production and accumulation of reactive oxygen species (ROS), which lead to a damage in the structure of proteins, lipids, and DNA. Therefore, the production of ROS may alter the normal physiological process by provoking damage to multiple cellular organelles and processes. Oxidative stress has been linked to heart disease, cancer, respiratory diseases, immune deficiency, stroke, Parkinson's disease, and other inflammatory or ischemic conditions. Antioxidants are substances that can prevent or slow damage to cells and tissues caused by ROS, unstable molecules that the body produces as a reaction to environmental and other pressures. The β-carotene, catechins, flavonoids, polyphenols, lycopene, lutein, selenium, vitamins A, C, D, E, and zeaxanthin are all common types of antioxidants and found in plant-based foods, especially fruits and vegetables. Each antioxidant has its own role and can interact with others to process and remove free radicals efficiently. Several studies have been conducted to investigate whether the use of dietary antioxidant supplements is associated with decreased risks of developing cancer in humans, mixed results were reported. For instance, daily use of supplement such as vitamin c, vitamin E, β-Carotene, and minerals such as selenium and zinc have shown its effectiveness by reducing the risk of developing prostate cancer among men and skin cancer among women.

氧化应激的定义是活性氧(ROS)的产生和积累不平衡所引起的事件,它导致蛋白质、脂类和 DNA 结构的破坏。因此,ROS 的产生可能会对多种细胞器和细胞过程造成损害,从而改变正常的生理过程。氧化应激与心脏病、癌症、呼吸系统疾病、免疫缺陷、中风、帕金森病和其他炎症或缺血性疾病有关。抗氧化剂是一种物质,可以防止或减缓 ROS 对细胞和组织造成的损害,ROS 是人体对环境和其他压力做出反应时产生的不稳定分子。β-胡萝卜素、儿茶素、类黄酮、多酚、番茄红素、叶黄素、硒、维生素 A、C、D、E 和玉米黄质都是常见的抗氧化剂,存在于植物性食物,尤其是水果和蔬菜中。每种抗氧化剂都有自己的作用,并能与其他抗氧化剂相互作用,有效地处理和清除自由基。有几项研究调查了使用膳食抗氧化剂补充剂是否与降低人类患癌症的风险有关,结果喜忧参半。例如,每日服用维生素 c、维生素 E、β-胡萝卜素等补充剂以及硒和锌等矿物质,可有效降低男性患前列腺癌和女性患皮肤癌的风险。
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引用次数: 0
Cancer Prevention and Treatment Based on Lifestyles. 基于生活方式的癌症预防和治疗。
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-55622-7_10
Deeba Amraiz, Aysha Karim Kiani, Uzma Azeem Awan, Tayyaba Amraiz, Bushra Azeem Awan, Muhammad Irfan

Cancer morbidity and mortality incidence are rapidly increasing over the period of time. Cancer prevention, alongside innovative therapies and earlier detection, is considered a key strategy for reducing the overall cancer burden. Substantial evidence indicates a clear correlation between lifestyle factors and changes in nutrient metabolism. Approximately 5-10% of all cancer cases are attributed to genetic factors, whereas 90-95% are due to environmental and lifestyle factors, suggesting that lifestyle interventions have significant prospects for preventing various cancers. Healthy lifestyle changes, in particular healthy diets, physical activity, staying at a healthy weight, reduction or elimination of tobacco/alcohol consumption, and avoiding exposure to radiation and other carcinogens, are significant factors to be considered to tackle the challenges associated with cancer in modern society. This chapter aims to provide lifestyle intervention strategies to improve cancer prevention and risk reduction while promoting the health of cancer patients. The therapeutic role of some dietary regimens and supplements, as well as complementary and alternative health approaches, in cancer treatment is also discussed.

随着时间的推移,癌症发病率和死亡率迅速上升。预防癌症、创新疗法和早期发现被认为是减轻癌症总体负担的关键战略。大量证据表明,生活方式因素与营养代谢变化之间存在明显的相关性。在所有癌症病例中,约有 5-10%归因于遗传因素,而 90-95% 则归因于环境和生活方式因素。改变健康的生活方式,尤其是健康饮食、体育锻炼、保持健康体重、减少或戒烟戒酒、避免接触辐射和其他致癌物质,是应对现代社会癌症挑战的重要因素。本章旨在提供生活方式干预策略,以改善癌症预防和降低风险,同时促进癌症患者的健康。本章还讨论了一些饮食疗法和补充剂以及补充和替代保健方法在癌症治疗中的治疗作用。
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引用次数: 0
Dietary Pattern and Cancer. 饮食模式与癌症
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-55622-7_8
Sara Mumtaz, Nosheen Akhtar, Awais Ahmed, Asma Saleem Qazi

Diet play an important role in the development of cancer. A lot of research has been done on the role of individual nutrients or phytochemicals and cancer risk. Both harmful and beneficial associations of this nutrient have been observed with cancer. However, there is an interaction of individual dietary constituents to influence disease risk. On the other hand, examining the diet as a whole as is done in dietary patterns research may produce more accurate estimates and data that can be more easily translated into dietary recommendations. Dietary patterns and cancer research are becoming increasingly common in the epidemiology literature, and novel dietary patterns are being generated at a rapid pace. However, major issues remain over whether one general "healthy" dietary pattern can be suggested for cancer prevention or whether several diets should be advocated for different forms of cancer protection. It is challenging to study typical human diet in animal model that is appropriate for cancer prevention. Some dietary patterns, such as the ketogenic diet or macronutrient composition alteration, have been investigated more extensively in animal models than in humans in terms of cancer prevention, and bigger human observational studies are now needed to advise dietary guidelines. The question of whether to adapt nutritional guidelines to population subgroups based on susceptibility factors (for example, family history, sex, age, other lifestyle factors or comorbidities, metabolomics signatures, or microbiota-based profiles) is still open and will be crucial in moving the field forward.

饮食在癌症发病中扮演着重要角色。关于个别营养素或植物化学物质与癌症风险的作用,已经进行了大量研究。已观察到这种营养素与癌症的有害和有益关系。然而,单个膳食成分之间存在相互作用,从而影响疾病风险。另一方面,像膳食模式研究那样对整个膳食进行研究,可能会得出更准确的估计和数据,从而更容易转化为膳食建议。膳食模式和癌症研究在流行病学文献中越来越常见,新的膳食模式也在快速产生。然而,对于是否可以建议一种通用的 "健康 "膳食模式来预防癌症,或者是否应该提倡几种膳食来保护不同形式的癌症,仍然存在重大问题。在动物模型中研究适合预防癌症的典型人类饮食具有挑战性。在预防癌症方面,一些饮食模式,如生酮饮食或改变宏量营养素组成,在动物模型中的研究比在人体中的研究更为广泛,现在需要更多的人体观察研究来为饮食指南提供建议。是否根据易感因素(如家族史、性别、年龄、其他生活方式因素或合并症、代谢组学特征或基于微生物群的特征)调整营养指南以适应人群亚组的问题仍未解决,这对推动该领域的发展至关重要。
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引用次数: 0
Diet, Gut Microbes, and Cancer. 饮食、肠道微生物与癌症
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-55622-7_7
Asma Saleem Qazi, Ubaid Ur Rahman, Bilal Ahmad, Waseem Safdar, Saeed Ahmad, Sara Mumtaz

Gut microbes are important and may play important role in spreading cancers specially the gastrointestinal malignancies preferably colorectal cancers. Gut microbes and diet can influence the tissues in gastrointestinal tract increasing the risk of cancer spread. Insufficient nutrient intake and imbalance diet can disturb the microbiome of gastrointestinal tract causing metabolism of xenobiotics which is beneficial as well as detrimental. Dietary imbalance may also weaken the immune system which is another reason for spreading and development of cancers. The triage of gut microbiome, host immune system, and dietary patterns may help the initiation of mechanism of carcinogenesis. In addition to its role in carcinogenesis and tumor development, there is still growing evidence as to how intestinal microflora influences the efficacy and toxicity of chemotherapy and immunotherapy by the gut microbiome. It can therefore be used as a biomarker to predict treatment response or poor response and can also be modified to improve cancer treatment.

肠道微生物非常重要,可能在癌症扩散,特别是胃肠道恶性肿瘤,尤其是结肠直肠癌扩散中扮演重要角色。肠道微生物和饮食会影响胃肠道组织,增加癌症扩散的风险。营养摄入不足和膳食失衡会扰乱胃肠道微生物群,导致有益或有害的异生物代谢。饮食失衡还可能削弱免疫系统,这是癌症扩散和发展的另一个原因。对肠道微生物组、宿主免疫系统和饮食模式进行分流可能有助于启动致癌机制。除了在致癌和肿瘤发展中的作用外,越来越多的证据表明,肠道微生物群如何影响化疗和免疫疗法的疗效和毒性。因此,肠道微生物组可作为预测治疗反应或不良反应的生物标志物,也可通过改变肠道微生物组来改善癌症治疗。
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引用次数: 0
Micronutrients Importance in Cancer Prevention-Minerals. 微量营养素在癌症预防中的重要性--矿物质。
Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1007/978-3-031-55622-7_6
Rida Fatima Saeed, Uzma Azeem Awan, Shaista Aslam, Asma Saleem Qazi, Muhammad Zeeshan Bhatti, Nosheen Akhtar

Cancer, a non-communicable disease with diverse kinds is one of the major global problems with high incidence and no proven method to prevent or treat. Minerals including trace elements are significant micronutrients for preserving the body's typical physiological function. In contrast to extremely processed industrial food, they are rich in natural sources of food and frequently included in nutritional supplements. The daily intake, storage capacities, and homeostasis of micronutrients depend on specific dietary practices in contemporary civilization and can be disturbed by various malignancies. Varied minerals have different effects on the status of cancer depending on how they affect these pathways. The outcomes could differ depending on the mineral such as calcium's supply and the cancer's location. A mineral called zinc helps the immune system function better and aids in wound healing. On the other hand, selenium exhibits anti-oxidant functions and has a dose-response relationship with many cancer types. However, this component can make the patient's condition worse. Although the body produces free radicals when iron is deficient, anaemia affects a patient's quality of life and ability to receive therapy. This chapter compiles the knowledge of minerals connected to unusual accumulation or depletion states in various malignancies.

癌症是一种种类繁多的非传染性疾病,是全球主要问题之一,发病率很高,却没有行之有效的预防或治疗方法。包括微量元素在内的矿物质是维持人体典型生理功能的重要微量营养素。与经过极度加工的工业食品相比,矿物质在天然食物中含量丰富,并经常被纳入营养补充剂中。微量元素的日常摄入量、储存能力和平衡取决于当代文明中的特定饮食习惯,并可能受到各种恶性肿瘤的干扰。各种矿物质对癌症状态的影响各不相同,这取决于它们如何影响这些途径。不同的矿物质,如钙的供应和癌症的位置,会产生不同的结果。一种名为锌的矿物质能帮助免疫系统更好地发挥作用,并有助于伤口愈合。另一方面,硒具有抗氧化功能,与许多癌症类型有剂量反应关系。然而,这种成分会使患者的病情恶化。虽然缺铁时身体会产生自由基,但贫血会影响患者的生活质量和接受治疗的能力。本章汇编了各种恶性肿瘤中与异常积累或耗竭状态有关的矿物质知识。
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引用次数: 0
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Cancer treatment and research
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