研究动态
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结肠腺瘤途径与结直肠癌发展的性别差异。

Sex Difference of Colon Adenoma Pathway and Colorectal Carcinogenesis.

发表日期:2023 Aug 29
作者: Yonghoon Choi, Nayoung Kim
来源: Cellular & Molecular Immunology

摘要:

结直肠癌(CRC)是男女性别均最常见的癌症发病原因之一,但存在性别差异。首先,已有报道表明肿瘤复发和生存率存在性别特异性差异。例如,相较于女性,男性患CRC的发病率约高1.5倍,早于女性发病4-8年,这表明雌激素在该疾病中的保护作用。此外,女性患者患右侧(近端)结肠癌的风险较高,而右侧结肠癌与左侧(远端)结肠癌相比,其临床特征更为侵袭性。也就是说,左侧和右侧CRC在致癌机制上存在差异,左侧结肠癌中常见的是染色体不稳定途径,而右侧结肠癌中常见的是微卫星不稳定途径和锯齿途径。认为肠癌发生机制的背景中存在性别差异。CRC的性别差异有两个方面,一是性异形(激素和基因方面的生物差异),二是性别差异(社会态度和行为的非生物差异)。最近,关于结肠腺瘤途径的性别差异以及CRC致癌过程中基因和蛋白质表达生物学、内分泌细胞信号转导的性异形有了积累。此外,行为模式可能导致对饮酒或吸烟、饮食和体力活动等危险因素的暴露差异。因此,了解与CRC风险相关的性别/性别相关的生物学和社会文化差异将有助于制定筛查、治疗和预防方案,以降低死亡率并改善生活质量。本综述论述了结肠腺瘤途径中的性别/性别差异以及CRC的临床病理学、生物学、分子学和社会文化方面的各个方面。版权所有 ©2023年韩国性医学与男科学会。
Colorectal cancer (CRC) is one of the most common causes of cancer morbidity in both sexes but shows sex differences. First, sex-specific differences in tumor recurrence and survival rates have been reported. For example, the development of CRC is found about 1.5 times higher and 4-8 years earlier in males compared to females, suggesting the protective role of estrogen in the disease. Furthermore, female patients have a higher risk of developing right-sided (proximal) colon cancer than male patients, which is known to have more aggressive clinical character compared to left-sided (distal) colon cancer. That is, left and right CRCs show differences in carcinogenic mechanism, that the chromosomal instability pathway is more common in left colon cancer while the microsatellite instability and serrated pathways are more common in right colon cancer. It is thought that there are sex-based differences on the background of carcinogenesis of CRC. Sex differences of CRC have two aspects, sexual dimorphism (biological differences in hormones and genes) and gender differences (non-biological differences in societal attitudes and behavior). Recently, sex difference of colon adenoma pathway and sexual dimorphism in the biology of gene and protein expression, and in endocrine cellular signaling in the CRC carcinogenesis have been accumulated. In addition, behavioral patterns can lead to differences in exposure to risk factors such as drinking or smoking, diet and physical activity. Therefore, understanding sex/gender-related biological and sociocultural differences in CRC risk will help in providing strategies for screening, treatment and prevention protocols to reduce the mortality and improve the quality of life. In this review, sex/gender differences in colon adenoma pathway and various aspects such as clinicopathological, biological, molecular, and socio-cultural aspects of CRC were described.Copyright © 2023 Korean Society for Sexual Medicine and Andrology.