肥胖导致甲状腺癌发生发展的潜在机制
The Potential Mechanisms by Which Obesity Contributes to the Occurrence and Development of Thyroid Cancer
DOI: 10.12677/acm.2026.1662363, PDF,   
作者: 吕晓霞, 廖 琳*:山东第一医科大学第一附属医院,山东省千佛山医院内分泌与代谢病科,山东 济南
关键词: 甲状腺癌肥胖胰岛素抵抗氧化应激Thyroid Cancer Obesity Insulin Resistance Oxidative Stress
摘要: 近年来,甲状腺癌发病率急剧上升,与全球肥胖患病率增长同步,提示两者存在潜在关联。本文系统综述了肥胖导致甲状腺癌发生发展的多种分子机制:肥胖相关的脂肪因子紊乱,包括脂联素水平降低、瘦素水平升高及其通过AKT/mTOR/PI3K和ERK/MAPK通路促进肿瘤细胞增殖、迁移和血管生成;促炎细胞因子IL-6和TNF-α升高通过JAK/STAT通路促进上皮–间充质转化和肿瘤转移;高胰岛素血症和胰岛素抵抗通过胰岛素受体及IGF-1系统增强促甲状腺激素的有丝分裂作用;雌激素通过ER-α/ER-β失衡促进甲状腺癌细胞增殖;COX-2上调、慢性低度炎症状态及氧化应激共同构成促肿瘤微环境。此外,膳食炎症指数、癌症相关脂肪细胞与肿瘤的“串扰”以及局部异位脂肪组织沉积也在肿瘤进展中发挥重要作用。生活方式干预、减重及降低肥胖发生率对甲状腺癌的预防和治疗具有关键意义,是未来研究的重要方向。
Abstract: In recent years, the incidence of thyroid cancer has risen sharply, coinciding with the global increase in obesity prevalence, suggesting a potential association between the two. This article systematically reviews the various molecular mechanisms by which obesity leads to the occurrence and development of thyroid cancer: dysregulation of obesity-related adipokines, including decreased adiponectin levels and increased leptin levels, which promote tumor cell proliferation, migration, and angiogenesis through the AKT/mTOR/PI3K and ERK/MAPK pathways; elevated pro-inflammatory cytokines IL-6 and TNF-α promote epithelial-mesenchymal transition and tumor metastasis through the JAK/STAT pathway; hyperinsulinemia and insulin resistance enhance the mitogenic effect of thyroid stimulating hormone through the insulin receptor and IGF-1 system; estrogen promotes thyroid cancer cell proliferation through the imbalance of ER-α/ER-β; COX-2 upregulation, chronic low-grade inflammation state, and oxidative stress jointly constitute the tumor-promoting microenvironment. Additionally, dietary inflammatory index, cancer-related adipocytes, and “cross-talk” between tumors and fat cells, as well as local ectopic fat tissue deposition also play important roles in tumor progression. Lifestyle intervention, weight loss, and reduction of obesity incidence are of crucial significance for the prevention and treatment of thyroid cancer and are important directions for future research.
文章引用:吕晓霞, 廖琳. 肥胖导致甲状腺癌发生发展的潜在机制[J]. 临床医学进展, 2026, 16(6): 1491-1503. https://doi.org/10.12677/acm.2026.1662363

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