化學預防於結腸直腸癌之文獻回顧

Review of chemoprevention of colorectal cancer

梁漢輝(Hon-Fai Leong)

指導教授 ： 蔡女滿 ； 唐海誼

中山醫學大學/醫學科技學院/醫學檢驗暨生物技術學系碩士班/碩士(2018年)

摘要

結腸直腸癌(CRC)為全球第三最常見的癌症，在許多亞洲國家，包括中國、日本、韓國和台灣等，結腸直腸癌的發病率正在快速上升。根據PDQ癌症綜合訊息庫的資料顯示，肥胖、不健康飲食(多紅肉少纖維)、吸煙及年齡等因素已涉及CRC患病率較高的風險因素，且CRC與遺傳關系密切。儘管利用結腸鏡檢查使結腸直腸癌的發生率及死亡率下降，但癌變的形式及發展與生活環境、方式及遺傳有關。起因包括染色體的不穩定性(CIN)、CpG島甲基化表型(CIMP)和微衛星不穩定性(MSI)三種相關，且與腫瘤抑制基因(TSG)、MMR基因，原癌基因APC及KRAS等的突變相關，影響APC/β-catenin/Tcf等路徑。故此，利用飲食方法來對結腸直腸癌的預防、發展、逆轉及延緩作出化學預防。本文會以糙米(Unpolished rice)、薑黃素(Curcumin)及白藜蘆醇(Resveratrol)對CRC的發展作出化學預防。糙米通過阻礙細胞週期G2/M期誘導細胞凋亡、降低COX-2的表達及降低GSH的水平來達到化學預防的效果；薑黃素通過降低COX-2、Cyclin D1的表達、阻斷NF-κB活化、抑制AP-1活化及上調p21、p53及PPAR-γ來誘導細胞凋亡。白藜蘆醇通過降低Cyclin D1的表達水平來誘導細胞凋亡。

關鍵字

化學預防 ； 風險因素 ； 糙米 ； 薑黃素

並列摘要

Colorectal cancer is the third most common cancer in the world. In many Asian countries, including China, Japan, Korea and Taiwan, the incidence of colorectal cancer is rising rapidly. According to the PDQ Cancer Information Summaries, factors such as obesity, unhealthy diet (too much meat but less fibres), smoking and age have been associated with higher risk factors for CRC prevalence, and also highly related to genetic factors. Although colonoscopy was used to reduce the incidence and mortality of colorectal cancer, the form and development of carcinogenesis are also related to living environment, life style and heredity. The causes of CRC are mainly related between chromosomal instability (CIN), CpG island methylator phenotype (CIMP) and microsatellite instability (MSI), and the mutations of tumor suppressor gene (TSG), MMR gene, Adenomatous polyposis coli and KRAS are also associated and hence affecting APC/β-catenin/Tcf pathways. Therefore, dietary methods are used to prevent, develop, reverse, and postpone chemoprevention of colorectal cancer. This passage will use unpolished rice, curcumin and resveratrol to prevent the development of CRC. Unpolished rice achieves chemoprevention effect by hindering cell cycle phase G2/M to induce cell apoptosis, decreasing of COX-2 expression, and decreasing of GSH level; curcumin induces cell apoptosis by decreasing the expression of COX-2 and Cyclin D1, blocking NF-κB activation, inhibiting the activation of AP-1 and up-regulating p21, p53 and PPAR-γ. Resveratrol induces cell apoptosis by decreasing the expression levels of Cyclin D1.

並列關鍵字

Chemoprevention ； risk factor ； unpolished rice ； curcumin

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