超重、肥胖是包括心血管疾病、2 型糖尿病和代谢综合征等多种疾病的主要危险因素,并对恶性肿瘤风险和预后产 生负面影响。 肥胖已被证明是一些恶性肿瘤的独立危险因素,包括乳腺癌、子宫内膜癌、卵巢癌、胃癌、结直肠癌、肾癌、食管 腺癌、胰腺导管腺癌和肝癌等。 但关于肥胖促进肿瘤发生的机制知之甚少,目前主要集中在肥胖后的胰岛素抵抗、脂肪因子 失调、性激素失衡、全身炎症、免疫系统变化和肠道菌群失调。 这些机制并不是单独地在起作用,而是以炎症为基础,相互联 系、相互促进肿瘤的发生。 肥胖对恶性肿瘤的发展和死亡率的影响,大部分可以通过饮食结构的调整和增加体育锻炼来预 防。 以抗炎为基础的药物治疗可作为预防的优先策略,减重手术也为肥胖相关恶性肿瘤的预防和治疗提供更多选择。 本文 将综述超重和肥胖促进恶性肿瘤发生、发展的机制,并探讨未来肥胖患者的肿瘤预防和治疗措施。

Obesity and overweight increase the risk and worsen the prognosis of cancer and are the primary risk factors for numerous diseases such as cardiovascular disease type 2 diabetes and metabolic syndrome. Obesity has been shown to be an independent risk factor for some cancers including breast cancer endometrial cancer ovarian cancer gastric cancer colorectal cancer renal cancer esophageal adenocarcinoma pancreatic ductal adenocarcinoma and liver cancer. The mechanism of obesity - promoting cancers which largely focuses on insulin resistance fat factor imbalance sex hormone imbalance systemic inflammation immune system alterations and intestinal flora imbalance after obesity is poorly understood. These systems interact and support carcinogenesis on the basis of inflammation they do not function independently. Most of the effects of obesity on the development and mortality of cancer can be prevented by adjusting diet and increasing physical exercise. Anti-inflammatory-based drug therapy can be used as a priority strategy for prevention and bariatric surgery also provides more options for preventing and treating obesity-related cancer. The mechanism by which obesity and overweight contribute to the formation and development of cancer will be discussed in this article along with future strategies for treating and preventing cancer in obese people.