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结直肠癌是危害人类健康的恶性肿瘤之一,在全世界其发病率和死亡率分别居第2位和第4位。目前中国内地结直肠癌发病率以4.71%逐年递增,远超2%的国际水平,居我国癌症死因的第4位、第5位。尽管目前的规范化综合治疗在很大程度上延长了晚期结直肠癌患者的生存期,结果仍然不能令人满意。大量研究显示Toll样受体4(Toll-like receptor4,TLR4)/髓样分化因子88(myeloid differentiation factor88,MyD88)信号通路是介导机体炎症和免疫的桥梁,诸多学者对其进行深入研究,发现TLR4、MyD88在结直肠癌细胞及组织中也均有表达,且TLR4可能通过不同的信号转导途径促进肿瘤细胞增殖、抑制肿瘤细胞凋亡及免疫逃逸,这些机制参与炎症相关性肿瘤的发生、发展。本文就肠道慢性炎症与结直肠癌发生、进展的关系,及TLR4/MyD88信号通路在其中的作用机制进行综述。
Colorectal cancer is one of the malignant tumors that endanger human health. Its morbidity and mortality are ranked second and fourth respectively in the world. At present, the incidence of colorectal cancer in mainland China increases annually by 4.71%, far exceeding the international standard of 2%, ranking No. 4 and No. 5 in the cause of cancer in China. Although current standardized and comprehensive treatment greatly prolongs the survival of patients with advanced colorectal cancer, the result is still unsatisfactory. Numerous studies have shown that the Toll-like receptor 4 (TLR4) / myeloid differentiation factor 88 (MyD88) signaling pathway is a bridge that mediates the inflammation and immunity of the body. Many scholars have conducted in-depth studies and found that TLR4, MyD88 are also expressed in colorectal cancer cells and tissues, and TLR4 may promote tumor cell proliferation, inhibit tumor cell apoptosis and immune escape by different signal transduction pathways, and these mechanisms are involved in the occurrence of inflammation-related tumors, development of. This article reviews the relationship between chronic inflammatory bowel disease and the occurrence and progression of colorectal cancer and the mechanism of TLR4 / MyD88 signaling pathway.