目的:癌症仍然是一个重大的全球卫生挑战,影响数百万人,并给全球医疗保健系统带来沉重负担。最近的研究表明肥胖和癌症之间有着复杂的关系,肥胖会增加各种癌症的风险,同时有可能改善确诊患者的预后,一种被称为“肥胖悖论”的现象。在这项研究中,我们使用1781例患者的队列研究肥胖对肿瘤特征的影响,包括基因表达,通路功能障碍,遗传改变和免疫浸润。
方法:患者样本跨越10种不同的癌症类型,并从癌症基因组图谱中获得,带有体重指数(BMI)的注释,年龄,性别,肿瘤大小和肿瘤基因表达数据。
结果:当我们比较肥胖和非肥胖患者之间大肿瘤(T3-T4)与小肿瘤(T1-T2)的比例时,我们发现肥胖患者倾向于出现较小的,侵袭性较小的肿瘤,表现出不同的基因表达谱,特别是在代谢和增殖途径中。此外,肥胖患者中较小的肿瘤表现出更高的免疫细胞浸润和增加的T细胞多样性,表明增强的免疫活性。
结论:综合来看,这些发现强调了肥胖对肿瘤生物学的影响,考虑患者生理和肿瘤特征的个性化治疗策略。
OBJECTIVE: Cancer continues to be a major global health challenge, affecting millions of individuals and placing substantial burdens on healthcare systems worldwide. Recent research suggests a complex relationship between obesity and cancer, with obesity increasing the risk of various cancers while potentially improving outcomes for diagnosed patients, a phenomenon termed the \"obesity paradox\". In this study, we used a cohort of 1781 patients to investigate the impact of obesity on tumor characteristics, including gene expression, pathway dysfunction, genetic alterations and immune infiltration.
METHODS: Patient samples spanned 10 different cancer types, and were obtained from the Cancer Genome Atlas, with annotations for body mass index (BMI), age, sex, tumor size and tumor gene expression data.
RESULTS: When we compared the proportion of large (T3-T4) to small tumors (T1-T2) between obese and non-obese patients, we found that obese patients tended to present with smaller, less invasive tumors and exhibited distinct gene expression profiles, particularly in metabolic and proliferative pathways. Moreover, smaller tumors in obese patients show higher immune cell infiltration and increased T cell diversity, suggesting enhanced immune activity.
CONCLUSIONS: Taken together, these findings highlight the influence of obesity on tumor biology, with implications for personalized treatment strategies that consider patient physiology alongside tumor characteristics.