2013-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/648762摘要：全世界每年有幾百萬人死於癌症，因此癌症仍是目前醫學重要課題。癌症病人的存活期是癌症病人照顧非常重的指標。癌症的期別、惡病質以及身體功能是癌症病人存活期的重要決定因子。癌症惡病質是能量平衡失調的情況。單核球及巨噬細胞在癌症惡病質扮演重要的角色。它們會跟癌細胞發生交互作用，同時釋放許多發炎細胞激素導致惡病質的產生，造成肌肉及脂肪組織的消瘦。因此發炎細胞激素的不當製造或功能異常是造成惡病質的重要原因。許多證據顯示癌症病人周邊血液單核球及癌組織內的巨噬細胞功能不但會受到腫瘤的影響，而且跟癌症的進程及病人的預後有關。脂締素是具有抗發炎作用及抑制癌細胞的脂肪細胞激素。我們先前研究證實單核球不僅會表現的脂締素，而且會抑制單核球的黏著作用。我們去年國科會計畫更進一步發現胃癌病人周邊血液單核細胞表現脂締素的表現量和病人存活期呈現正相關，強化了癌症病人單核球功能的改變跟病人預後有關的證據(已投稿中)。我們還需要更大的世代研究來印證這樣的結果，進一步研究癌細胞調控單核球表現脂締素的機轉及其對單核球分化與癌症進程的關係。同時探討單核球表現脂締素對癌症惡病質中肌肉及脂肪組織消瘦的影響。研究結果可以作為癌症病人預後的評估、癌症治療效果的評估及發展癌症治療的基礎。<br> Abstract: Cancer is a great challenge in medicine, because several million people die of cancer each year. Survival is an important outcome indicator in the care of cancer patients. Tumor stage, presence of cachexia-related symptoms and functional performance have been shown to be important factors for survival in cancer patients. Cancer cachexia is a situation of disturbances in energy homeostasis. Mopnocytes and macrophages have been shown to be important roles in cancer cachexia. They interact with cancer cells and secret proinflammatory cytokines, resulting in metabolic disturbances. Abnormal production and dysfunction of these cytokines plays important roles in cancer cachexia. Several lines of evidence have demonstrated that functions of circulating monocytes and tumor-associated macrophages are altered in cancer patients, which is closely associated with cancer progression. Adiponectin is an important adipokine with anti-inflammatory and anti-cancer property. In addition, we find that monocyte-expressed adiponectin inhibits monocyte adhesion. In our National Science Council project last year, we find that adiponectin levels in peripheral mononuclear cells are positively correlated with survival in gastric cancer patients (in submission). Thus, These results reinforce survival is related to the altered monocyte functions in cancer patients. We need a larger scale cohort study to confirm the results, so we will conduct the three-year study to further investigate the mechanism for cancer cells to regulate adiponectin expression in monocytes/macrophages, and the roles of monocyte-expressed adiponectin in monocyte/macrophage functions and cancer progression. Meanwhile, we will investigate the role of adiponectin expressed by monocytes/macrophages in wasting of muscle and adipose tissue in cancer cachexia. In addition to prognostic prediction, the results may be outcome indicators of anti-cancer therapy. Furthermore, to regulate adiponectin expression in monocytes/macrophages may be potential strategies for cancer treatment.癌症惡病質存活期巨噬細胞單核球細胞激素脂締素cancercachexiasurvivalmacrophagemonocytecytokineadiponectin