肿瘤恶液质是一种复杂的多因素系统综合征,以代谢紊乱介导肌肉萎缩和体重减轻为主要特征,干扰治疗方案实 施,导致患者生活质量下降和生存期缩短。 肿瘤恶液质影响 50% ~ 80%的肿瘤患者,胰腺癌、肺癌、胃癌等肿瘤更有高达 85% 以上的恶液质发生率,且 20%的肿瘤患者因为恶液质代谢的巨大消耗而直接死亡。 肿瘤恶液质发病机制非常复杂,目前关于 肿瘤恶液质的代谢发病特征、发病机制和药物防治研究备受关注。 代谢组学技术通过研究机体代谢物构成和浓度的变化揭 示疾病代谢发病特征,近年来广泛用于肿瘤和代谢性疾病的特征和生物标志物研究,阐明多组织脏器代谢相互作用关系。 本 文总结肿瘤恶液质的代谢改变特征及其代谢途径,阐明肿瘤恶液质的基本改变机制和生物标志物研究现状,尤其是不同类型 肿瘤介导恶液质发病的机制及其临床代谢差异,比较临床样本和模型动物肿瘤恶液质代谢轮廓和生物标志物,分析不同肿瘤 恶液质的代谢相互作用关系,以期为肿瘤恶液质的诊断和防治研究提供新思路,为药物靶点和临床干预开发提供新思路。

Cancer cachexia is a complex multifactorial systemic syndrome that characterized by metabolic disorders mediating muscle atrophy and weight loss. Cancer cachexia is not only a contraindication to the comprehensive cancer treatment such as chemotherapy but also a deteriorating state with decreasing quality of life and short survival. Cancer cachexia occurs in 50%-80% of cancer patients with an incidence of over 85% in patients with pancreatic lung and gastric cancer. In addition 20% of cancer patients die as a result of the enormous wasting associated with cachexia. Metabolomics technology reveals the metabolic pathogenesis of diseases through the study of changes in the composition and concentration of metabolites and has been widely used in recent years for the characterisation and biomarker studies of tumours and metabolic diseases to elucidate the metabolic interactions of multiple tissues. In the present study we summarised the metabolic changes and pathways of cancer cachexia to elucidate the fundamental metabolic reprogramming of cancer cachexia. We reviewed the current status of biomarker research and the mechanism of cancer cachexia resulting from different types of cancer. By comparing the metabolic profiles of cancer cachexia from clinical samples and animal models we analysed the metabolic interactions of different cancer cachexias. The present study not only provides new ideas for the diagnosis and prevention of cancer cachexia but also new strategies for drug target research and clinical intervention research.